| Neurolytic celiac plexus block reduces occurrence and duration of terminal delirium in patients with pancreatic cancer. | |
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MedLine Citation:
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PMID: 22990527 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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PURPOSE: WHO's three step ladder sometimes cannot provide adequate pain relief for pancreatic cancer. Some patients develop terminal delirium (TD). The aim of this study was to test if the addition of a celiac plexus block (CPB) to pharmacotherapy could reduce the incidence of TD. METHODS: Pancreatic cancer patients under the care of our palliative-care team were investigated with regard to the duration and occurrence of TD, pain scores [numerical rating score (NRS)] and daily opioid dose. Between August 2007 to September 2008, 17 patients received only pharmacotherapy (control group). Then, we modified our guideline for analgesia, performing CPB 7 days after the first intervention of our team. Between October 2008 to September 2009, 19 patients received CPB. RESULTS: The opioid doses in CPB group were significantly lower both at 10 days after the first intervention (3 days after CPB) (27 ± 11 vs. 66 ± 82 mg; p = 0.029) and 2 days before death (37 ± 25 vs. 124 ± 117 mg; p = 0.009). NRS in the CPB group were significantly lower both at 10 days after the first intervention (0 [0-2] vs. 3 [2-5], p < 0.0001) and 2 days before death (1 [0-2] vs. 3 [1-4.5], p = 0.018). The occurrence and duration of TD in CPB group were both reduced (42 vs. 94 %, p = 0.019; and 1.8 ± 2.9 vs. 10.4 ± 7.5 days, p = 0.0003). CONCLUSION: The duration and occurrence of TD and the pain severity were significantly less in pancreatic cancer patients who underwent neurolytic CPB. |
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Authors:
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Young-Chang P Arai; Makoto Nishihara; Kunio Kobayashi; Tamotsu Kanazawa; Nobuhiko Hayashi; Yukio Tohyama; Kikuyo Nishida; Maki Arakawa; Chiharu Suzuki; Akiko Kinoshita; Miki Kondo; Satuki Matsubara; Nami Yokoe; Ruiko Hayashi; Aya Ohta; Jun Sato; Takahiro Ushida |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-9-19 |
Journal Detail:
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Title: Journal of anesthesia Volume: - ISSN: 1438-8359 ISO Abbreviation: J Anesth Publication Date: 2012 Sep |
Date Detail:
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Created Date: 2012-9-19 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8905667 Medline TA: J Anesth Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Multidisciplinary Pain Centre, Aichi Medical University, School of Medicine, 21 Karimata, Nagakutecho, Aichigun, Aichi, 480-1195, Japan, arainon@aichi-med-u.ac.jp. |
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