Celiac plexus neurolysis in treatment of chronic pain syndrome in patients with unresectable pancreatic cancer

Introduction. Pancreatic cancer is a disease with a severely unfavorable prognosis. In the majority of patients, tumors are initially unresectable. The most common complication of this pathology is chronic pain syndrome. The traditional method of its treatment is opioid analgesics. However, adverse effects of this treatment and negative effects on psychological and emotional state of the patients require the search for alternative methods of pain management, one of which is celiac plexus neurolysis.

Aim. To evaluate the effectiveness of celiac plexus neurolysis in patients with unresectable pancreatic cancer.

Materials and methods. The retrospective study included patients with unresectable pancreatic cancer complicated by chronic pain syndrome who underwent celiac plexus neurolysis between 2007 and 2010. The following parameters were evaluated: the effect of pain management according to the visual Analogue Scale (VAS), frequency in requirement for repeat neurolysis sessions, development of complications, as well as effectiveness and preservation of analgesic effect 8 weeks after the procedure (evaluated as preservation of significant difference compared to the baseline pain level per VAS). The quality of life of patients who underwent transcutaneous neurolysis was evaluated using the Russian version of the medical Outcomes Study-Short form-36 (MOS-Sf-36) questionnaire.

Results. The study included 12 patients. In 9 (75 %) patients, analgesic effect was observed after 1 neurolysis session. A repeat session was required for 3 (25 %) patients. Side effects of neurolysis were not observed in any of the patients. Evaluation of the quality of life was performed using the MOS-Sf-36 questionnaire. mean score of the general health scale prior to neurolysis was 41.6 ± 0.4; 1 month after the procedure it was significantly higher: 73.2 ± 0.6. On the men tal health scale, mean score after neurolysis increased from 34.8 ± 0.9 to 83.1 ± 0.9. Additionally, differences between values per the vAS scale before and after the procedure were statistically significant (р <0.01).

Conclusion. Our study confirmed the safety and effectiveness of different methods of neurolysis in treatment of chronic pain syndrome in patients with unresectable pancreatic cancer.

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