Efficacy of cross-sectional imaging guided sympathetic neurolysis in abdoiniuopelvic tumors

Aim of work

To study the efficacy of visceral neurolytic blocks in the abdominopelvic cancer when guided by ultrasound/CT.

Patients and methods

50 patients were selected randomly and prospectively from the pain clinic in NCI suffering from moderate-severe visceral pain (visual analogue score?≥?4) due to advanced abdominal and pelvic malignancy. Patients were divided into celiac plexus block-CPB (n = 25), superior hypogastric block-SHPB (n = 12) and ganglion impar block-GIB (n = 8) groups according to site of pain and then randomly and almost equally divided into subgroups of U/S and CT. Recording of baseline and postprocedure/follow up of visual analogue score (VAS), morphine consumption which constitute the primary outcome as well as patient global impression of change (PGIC) which represents the secondary outcome/quality of life. Complications at anytime during follow up were documented.

Results

There was significant (p < 0.001) reduction in post procedure VAS scores and morphine consumption after performing CPB and SHPB with satisfactory PGIC. Patients who performed GIB showed no significant change in pain scores or morphine consumption. There was a low complications rate with no major side effects.

Conclusion

This study shows that guided sympathetic neurolytic blocks significantly reduce abdominal/pelvic cancer pain and analgesic consumption with no significant complications.