Factors associated with successful response to neurolytic celiac plexus block in patients with upper abdominal cancer-related pain: a retrospective study

Hyun-Jung Kwon; Kyunghwan Jang; Jeong-Gil Leem; Jin-Woo Shin; Doo-Hwan Kim; Seong-Soo Choi

doi:10.3344/kjp.2021.34.4.479

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자료유형: 학술저널

저자정보: Hyun-Jung Kwon (University of Ulsan College of Medicine) Kyunghwan Jang (University of Ulsan College of Medicine) Jeong-Gil Leem (University of Ulsan College of Medicine) Jin-Woo Shin (University of Ulsan College of Medicine) Doo-Hwan Kim (University of Ulsan College of Medicine) Seong-Soo Choi (University of Ulsan College of Medicine)

저널정보: 대한통증학회 The Korean Journal of Pain The Korean Journal of Pain 제34권 제4호

발행연도: 2021.10

수록면: 479 - 486 (8page)

DOI: 10.3344/kjp.2021.34.4.479

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Background: Prior studies have reported that 40%-90% of the patients with celiac plexus-mediated visceral pain benefit from the neurolytic celiac plexus block (NCPB), but the predictive factors of response to NCPB have not been evaluated extensively. This study aimed to identify the factors associated with the immediate analgesic effectiveness of NCPB in patients with intractable upper abdominal cancer-related pain. Methods: A retrospective review was performed of 513 patients who underwent NCPB for upper abdominal cancer-related pain. Response to the procedure was defined as (1) a decrease of ≥ 50% or ≥ 4 points on the numerical rating scale (NRS) in pain intensity from the baseline without an increase in opioid requirement, or (2) a decrease of ≥ 30% or ≥ 2 points on the NRS from the baseline with simultaneously reduced opioid consumption after NCPB. Logistic regression analysis was performed to determine the factors associated with successful responses to NCPB. Results: Among the 513 patients included in the analysis, 255 (49.8%) and 258 (50.2%) patients were in the non-responder and responder group after NCPB, respectively. Multivariable logistic regression analysis showed that diabetes (odds ratio [OR] = 0.644, P = 0.035), history of upper abdominal surgery (OR = 0.691, P = 0.040), and celiac metastasis (OR = 1.496, P = 0.039) were the independent factors associated with response to NCPB. Conclusions: Celiac plexus metastases, absence of diabetes, and absence of prior upper abdominal surgery may be independently associated with better response to NCPB for upper abdominal cancer-related pain.

#Abdominal Pain #Analgesics #Cancer Pain #Celiac Plexus #Denervation #Logistic Models #Neoplasms #Nerve Block #Visceral Pain.

참고문헌 (38)

참고문헌 신청

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