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

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 associat...

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Autores principales: Kwon, Hyun-Jung, Jang, Kyunghwan, Leem, Jeong-Gil, Shin, Jin-Woo, Kim, Doo-Hwan, Choi, Seong-Soo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Pain Society 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8494952/
https://www.ncbi.nlm.nih.gov/pubmed/34593666
http://dx.doi.org/10.3344/kjp.2021.34.4.479
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author Kwon, Hyun-Jung
Jang, Kyunghwan
Leem, Jeong-Gil
Shin, Jin-Woo
Kim, Doo-Hwan
Choi, Seong-Soo
author_facet Kwon, Hyun-Jung
Jang, Kyunghwan
Leem, Jeong-Gil
Shin, Jin-Woo
Kim, Doo-Hwan
Choi, Seong-Soo
author_sort Kwon, Hyun-Jung
collection PubMed
description 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.
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spelling pubmed-84949522021-10-13 Factors associated with successful response to neurolytic celiac plexus block in patients with upper abdominal cancer-related pain: a retrospective study Kwon, Hyun-Jung Jang, Kyunghwan Leem, Jeong-Gil Shin, Jin-Woo Kim, Doo-Hwan Choi, Seong-Soo Korean J Pain Clinical Research Articles 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. The Korean Pain Society 2021-10-01 2021-10-01 /pmc/articles/PMC8494952/ /pubmed/34593666 http://dx.doi.org/10.3344/kjp.2021.34.4.479 Text en © The Korean Pain Society, 2021 https://creativecommons.org/licenses/by-nc/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Research Articles
Kwon, Hyun-Jung
Jang, Kyunghwan
Leem, Jeong-Gil
Shin, Jin-Woo
Kim, Doo-Hwan
Choi, Seong-Soo
Factors associated with successful response to neurolytic celiac plexus block in patients with upper abdominal cancer-related pain: a retrospective study
title Factors associated with successful response to neurolytic celiac plexus block in patients with upper abdominal cancer-related pain: a retrospective study
title_full Factors associated with successful response to neurolytic celiac plexus block in patients with upper abdominal cancer-related pain: a retrospective study
title_fullStr Factors associated with successful response to neurolytic celiac plexus block in patients with upper abdominal cancer-related pain: a retrospective study
title_full_unstemmed Factors associated with successful response to neurolytic celiac plexus block in patients with upper abdominal cancer-related pain: a retrospective study
title_short Factors associated with successful response to neurolytic celiac plexus block in patients with upper abdominal cancer-related pain: a retrospective study
title_sort factors associated with successful response to neurolytic celiac plexus block in patients with upper abdominal cancer-related pain: a retrospective study
topic Clinical Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8494952/
https://www.ncbi.nlm.nih.gov/pubmed/34593666
http://dx.doi.org/10.3344/kjp.2021.34.4.479
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