Онкология EVALUATION OF PAIN SYNDROME AFTER CELIAC PLEXUS BLOCKADE WITH SUBSEQUENT NEUROLYSIS IN PATIENTS WITH CHRONIC ABDOMINAL PAIN SYNDROME IN THE UPPER ABDOMINAL CAVITY
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EVALUATION OF PAIN SYNDROME AFTER CELIAC PLEXUS BLOCKADE WITH SUBSEQUENT NEUROLYSIS IN PATIENTS WITH CHRONIC ABDOMINAL PAIN SYNDROME IN THE UPPER ABDOMINAL CAVITY

УДК 616.32/-34-009.7-036.12-08

M.S. Burdyukov1,2, I.N. Yurichev1,2, A.M. Nechipay2, M.E. Isakova1, B.I. Dolgushin1

1N.N. Blokhin Russian Cancer Research Center, Moscow

2Russian Medical Academy of Postgraduate Education of Russian Ministry of Healthcare, Moscow

Burdyukov M.S. ― Cand. Med. Sc., Senior Researcher of Endoscopy Department of the N.N. Blokhin Russian Cancer Research Center, Associate Professor of Endoscopy Department of Russian Medical Academy of Postgraduate Education of Russian Ministry of Healthcare

23 Kashirskoe highway, Moscow, Russian Federation, 115478, tel. +7-903-686-40-54, e-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра.

Abstract. Chronic abdominal pain syndrome is present in most oncology diseases of abdominal cavity as well as in chronic pain form of chronic pancreatitis. Despite development of new chemotherapeutic drugs, new surgical methods of treating pain, pain management  the patients is still a dilemma as each of the methods has its own complications. Also each methods has their own deficiencies. One of the methods is percutaneous under US and CT-control and the other is neurolysis under endoscopic ultrasound control. Both methods are very useful and cause less complications. We performed a study to asses pain syndrome dynamics after endoscopic neurolysis and reveal most common response pattern to the method.

Purpose ― to study the dynamics of pain syndrome after endoscopic neurolysis and reveal most common response pattern to the method.

Design. In cases of 42 patients we enrolled in the study, with 60 interventions under endosonography performed to alleviate pain syndrome. Before intervention and the day after, as well as at time points at 1, 2, 4, 6 weeks after intervention, questionnaire with visual-analog scale were assessed. Statistical analysis of the date along with most common response patterns to the intervention were performed. 

Results. Analysis of difference between baseline pain syndrome level and pain level immediately after the procedure revealed that in one case pain level did not change, in 2 cases pain level insignificantly increased and decreased in 57 patients. Decrease of pain syndrome ranged between 5 and 90 scores, with mean decrease of 55,5 scores, mediana 60 scores. In quarter patients pain decrease ranged between 5 and 40 scores with range of decrease between 70 and 90 scores in other quater. Based on that, we concluded that in 95% patients (57 out of 60), neurolysis under endoscopic control decrease the pain that makes that the procedure is effective method of decreasing: the patients; mediana magnitude of pain syndrome decrease was 60 scores that proves significance of the effect on pain syndrome.

Conclusion. In this part of the study pain syndrome dynamics  was assesed on the base of questionnaire with visual-analog cale. Results of the study reveales that pain syndrome statistically significantly decrease in comparison with the baseline throughout the observation. There is a tendency to gradual increase in pain syndrome without reaching statistical significance. Most common patterns of dynamics of pain syndrome after the procedure were revealed that will help to predict results of dynamics after the procedure.

Key words: abdominal pain syndrome, neurolysis, under endoscopic ultrasound control.

 

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