Effectiveness of neurolytic sympathetic plexus block in a descriptive case series of patients with oncological pain

Keywords: Cancer pain, Opioid analgesics, Autonomic nerve block, Karnofsky performance status, Minimally invasive surgical procedures, Quality of life

Abstract

Introduction. Pain is the main symptom that occurs in 40% of cancer patients undergoing treatment and between 80% and 85% of patients with advanced cancer. Out of the pharmacological tools, opioids are an option with secondary effects, which makes interventional procedures important. The objective of the article is to demonstrate the impact of celiac or hypogastric plexus block in a three-month period on the pain control and quality of life of patients with abdominal oncological pain in order to generate knowledge of this topic in the healthcare sector. Methodology. A descriptive case series was conducted in a three-month period. Thirty-four adult patients with oncological abdominal pain with proposed celiac or superior hypogastric plexus block as a method of pain control were included and an analysis was conducted of the variables in the statistical program IBM SPSS Version 19. Results. Pain relief was found in 79.4% of the treated patients shortly after the procedure and in 33.3% of the treated patients after 3 months. No significant improvement was evidenced in the quality of life evaluated with the SF-36 questionnaire. Conclussions. The study found that patients with a Karnofsky performance score of < 50 had a high mortality rate after the block. The technique of phenolization and radiofrequency could have a better therapeutic response. More studies are needed to assess possible associations.

Author Biographies

Jennifer Jaimes-Cristancho, Fundación Oftalmológica de Santander (FOSCAL)

Médica Anestesióloga, Clínica FOSCAL - FOSCAL Internacional, Floridablanca, Santander, Colombia.

Mario Andrés Leotau, Fundación Oftalmológica de Santander (FOSCAL)

Médico, Anestesiólogo, Especialista en Medicina del Dolor y Cuidado Paliativo, Clínica de dolor Aliviar, Clínica FOSCAL-FOSCAL Internacional, Floridablanca, Santander, Colombia.

German William Rangel, Fundación Oftalmológica de Santander (FOSCAL)

Médico, Anestesiólogo, Especialista en Medicina del Dolor y Cuidado Paliativo, Clínica de dolor Aliviar, Clínica FOSCAL-FOSCAL Internacional, Floridablanca, Santander, Colombia.

Nelcy Miranda, CEO – COINS Research
Enfermera, Máster en Estudio y Tratamiento del dolor, Especialista en Epidemiología, Magíster en Gerencia de Negocios, CEO – COINS Investigaciones, Bogotá, Colombia.
Natalia García-Salazar, Fundación Oftalmológica de Santander (FOSCAL)

Médica, Residente de Anestesiología, Bucaramanga, Santander, Colombia.

Jully Andrea Rangel-Vera

Médica General, Toronto, Canadá.

References

Van Hecke O, Torrance N, Smith BH. Chronic pain epidemiology and its clinical relevance. Br J Anaesth. 2013 Jul;111(1):13-8. doi: 10.1093/bja/aet123.

Organización Mundial de la Salud. Programas nacionales de control del cáncer políticas y pautas para la gestión; 2004. Recuperado a partir de: https://www.paho.org/hq/dmdocuments/2012/OPS-Programas-Nacionales-Cancer-2004-Esp.pdf

Bruera E, Kim HN. Cancer Pain. JAMA. 2003;290(18):2476–2479. doi:10.1001/jama.290.18.2476

Auret K, Schug SA. Best Pract Res Clin Anaesthesiol. 2013 Dec;27(4):545-61. doi: 10.1016/j.bpa.2013.10.007. Epub 2013 Oct 15.

Gangi A, Buy X, Garnon J, Tsoumakidou G, Moser T, Bierry G, et al. Pain management in oncology. J Radiol 2011 Sep;92(9):801-813. DOI: 10.1016/j.jradio.2011.07.014

Prieto Ríos B, Navarro Expósito F, Molina Villaverde R, Álvarez-Mon Soto M. Tratamiento del dolor oncológico. Medicine-Programa de Formación Médica Continuada Acreditado 2009;10(24):1629-1633. https://doi.org/10.1016/S0211-3449(09)70010-4

Sancho JF, López G, Sancho A, Ávila C, Grande ML, Cavallo L, et al. Tratamiento del dolor oncológico. Psicooncología 2006;3(1):121-138. Recuperado a partir de: https://revistas.ucm.es/index.php/PSIC/article/view/PSIC0606130121A/15941

Goodman Gilman A. Las bases farmacológicas de la terapéutica, décima edición. México, editorial Mc Graw Hill Interamericana 2003;2:104-106. Recuperado a partir de: https://dvmbooks.weebly.com/uploads/2/2/3/6/22365786/2._goodman_and_gilman.pdf

De Leon-Casasola OA. Current developments in opioid therapy for management of cancer pain. Clin J Pain 2008 May;24 Suppl 10:S3-7. doi: 10.1097/AJP.0b013e31816b589f.

Mearis M, Shega JW, Knoebel RW. Does Adherence to National Comprehensive Cancer Network Guidelines Improve Pain-Related Outcomes? An Evaluation of Inpatient Cancer Pain Management at an Academic Medical Center. J Pain Symptom Manage. 2014 Sep;48(3):451-8. https://doi.org/10.1016/j.jpainsymman.2013.09.016

Celis-Rodriguez E, Birchenall C, de la Cal MA, Castorena Arellano G, Hernandez A, Ceraso D, Díaz Cortés JC, Dueñas Castell C, Jimenez EJ, Meza JC, Muñoz Martínez T, Sosa García JO, Pacheco Tovar C, Pálizas F, Pardo Oviedo JM, Pinilla DI, Raffán-Sanabria F, Raimondi N, Righy Shinotsuka C, Suárez M, Ugarte S, Rubiano S. Clinical practice guidelines for evidence-based management of sedoanalgesia in critically ill adult patients. Med Intensiva 2013 Nov;37(8):519-574. doi: 10.1016/j.medin.2013.04.001

Pernia A, Torres L. Tratamiento del dolor oncológico terminal intenso. Revista de la Sociedad Española del Dolor 2008;15(5):308-324. Recuperado a partir de: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1134-80462008000500005#back

De Andres J, Asensio-Samper JM, Fabregat-Cid G. Intrathecal delivery of analgesics. Methods Mol Biol. 2014;1141:249-78. doi: 10.1007/978-1-4939-0363-4_16

Brogan S, Junkins S. Interventional therapies for the management of cancer pain. J Support Oncol. 2010 Mar-Apr;8(2):52-9.

Birthi P, Sloan P. Interventional treatment of refractory cancer pain. Cancer J. 2013 Sep-Oct;19(5):390-6. doi: 10.1097/PPO.0b013e3182a631a2.

Nelson R. New nerve-block analgesia for patients with pancreatic cancer. Lancet Oncol 2004 Apr;5(4):201. DOI:https://doi.org/10.1016/S1470-2045(04)01442-1

Cepeda MS, Farrar JT. Economic evaluation of oral treatments for neuropathic pain. J Pain. 2006 Feb;7(2):119-28. DOI: 10.1016/j.jpain.2005.09.004

Delaplace M, Maitre F, Dufour T, Landrieux I, Gauthier P, Jebira P, et al. Two cases of cutaneous erythema following spinal cord stimulation]. Ann Dermatol Venereol. 2010 Apr;137(4):297-300. doi: 10.1016/j.annder.2010.02.017.

Cruccu G, Aziz T, Garcia‐Larrea L, Hansson P, Jensen T, Lefaucheur J, et al. EFNS guidelines on neurostimulation therapy for neuropathic pain. European Journal of Neurology 2007;14(9):952-970. DOI: 10.1111/j.1468-1331.2007.01916.x

Brogan S, Junkins S. Interventional therapies for the management of cancer pain. J Support Oncol 2010 Mar-Apr;8(2):52-59. Recuperado a partir de: https://www.ncbi.nlm.nih.gov/pubmed/20464881

Marcy PY, Magne N, Descamps B. Coeliac plexus block: utility of the anterior approach and the real time colour ultrasound guidance in cancer patient. Eur J Surg Oncol 2001 Dec;27(8):746-749. DOI: 10.1053/ejso.2001.1202

Staats PS, Hekmat H, Sauter P, Lillemoe K. The effects of alcohol celiac plexus block, pain, and mood on longevity in patients with unresectable pancreatic cancer: a double-blind, randomized, placebo-controlled study. Pain Med. 2001 Mar;2(1):28-34. DOI: 10.1046/j.1526-4637.2001.002001028.x

Bhatnagar S, Gupta M. Evidence-based Clinical Practice Guidelines for Interventional Pain Management in Cancer Pain. Indian J Palliat Care. 2015 May-Aug;21(2):137-47. doi: 10.4103/0973-1075.156466.

Guerrero M: Gómez A; Pérez S; Gómez A; Pedraza A. Correlación del estado funcional de Karnofsky con la supervivencia de pacientes con tumores de origen gastrointestinal en un servicio de cuidados paliativos. Asociación Mexicana de Cirugía General. Elseiver. 2014. Recuperado a partir de: https://www.elsevier.es/es-revista-cirujano-general-218-articulo-correlacion-del-estado-funcional-karnofsky-X1405009914734080

Adradra J; Calambas F; Díaz J. Características sociodemográficas y clínicas en una población con cáncer gástrico en el Cauca, Colombia. 2008. Asociaciones Colombianas de Gastroenterología, Endoscopia digestiva, Coloproctología y Hepatología. Recuperado a partir de:

https://www.redalyc.org/pdf/3377/337731589004.pdf

Fujii L; Clain E; Morris M; Levy J. Anterior spinal cord infarction with permanent paralysis following endoscopic ultrasound celiac plexus neurolysis. 2012; 44: E265–E266. doi: 10.1055/s-0032-1309708

Teixeria M; Neto E; Marinho J; Angelos J; Martìn M. Celiac plexus neurolysis for the treatment of upper abdominal cancer pain. Neuropsychiatric Disease and Treatment. 2013:9 1209–1212. doi: 10.2147/NDT.S43730

Viùdez A; Miranda C; Arias Fernando; et all. Situación actual en el tratamiento del cáncer gástrico. Rev Esp Enferm Dig. 2012 Mar 104(3). http://dx.doi.org/10.4321/S1130-01082012000300006

Wong GY, Schroeder DR, Carns PE, Wilson JL, Martin DP, Kinney MO, Mantilla CB, Warner DO. Effect of neurolytic celiac plexus block on pain relief, quality of life, and survival in patients with unresectable pancreatic cancer: a randomized controlled trial. JAMA. 2004 Mar 3;291(9):1092-9. DOI: 10.1001/jama.291.9.1092

Staats PS, Hekmat H, Sauter P, Lillemoe K. The effects of alcohol celiac plexus block, pain, and mood on longevity in patients with unresectable pancreatic cancer: a double-blind, randomized, placebo-controlled study. Pain Med. 2001 Mar;2(1):28-34. DOI: 10.1046/j.1526-4637.2001.002001028.x

Birthi P, Sloan P. Interventional treatment of refractory cancer pain. Cancer J 2013 Sep-Oct;19(5):390-396. DOI: 10.1097/PPO.0b013e3182a631a2

How to Cite
1.
Jaimes-Cristancho J, Leotau MA, Rangel GW, Miranda N, García-Salazar N, Rangel-Vera JA. Effectiveness of neurolytic sympathetic plexus block in a descriptive case series of patients with oncological pain. MedUNAB [Internet]. 2019 Nov. 29 [cited 2026 Mar. 9];22(3):330-4. Available from: https://revistasunabeduco.biteca.online/index.php/medunab/article/view/3337

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2019-11-29

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