A prospective, randomized study of EUS-guided celiac plexus neurolysis for pancreatic cancer: One injection or two?

Julia K. Leblanc, Mohammad Al-Haddad, Lee McHenry, Stuart Sherman, Michelle Juan, Kathleen McGreevy, Cynthia Johnson, Thomas Howard, Keith D. Lillemoe, John DeWitt

Research output: Contribution to journalArticle

58 Citations (Scopus)

Abstract

Background: The technique of alcohol injection during EUS-guided celiac plexus neurolysis (CPN) in patients with pancreatic cancerrelated pain has not been standardized. Objective: To compare pain relief and safety of alcohol given as 1 versus 2 injections during EUS-guided CPN (EUS-CPN). Secondary outcomes examined were characteristics that predict response and survival. Design: Single-blinded, prospective, randomized, parallel-group study. Setting: Tertiary-care center. Patients: This study involved patients with pancreatic cancerrelated pain. Intervention: EUS-CPN done by injecting 20 mL of 0.75% bupivacaine and 10 mL 98% alcohol into 1 or 2 sites at the celiac trunk. Participants were interviewed by telephone at 24 hours and weekly thereafter. Main Outcome Measurements: Time until onset of pain relief, duration of pain relief, complications. Results: Fifty patients (mean age 63 years; 24 men) were enrolled and randomized (29 in 1-injection, 21 in 2-injections groups). Pain relief was observed in 37 (74%) patients: 20 (69%) in the 1-injection group and 17 (81%) in the 2-injection group (chi-square P =.340). Median onset of pain relief was 1 day for both 1-injection (range 1-28 days) and 2-injection (range 1-21 days) groups (Mann-Whitney P =.943). Median duration of pain relief in the 1-injection and 2-injection groups was 11 weeks and 14 weeks, respectively (log-rank P =.612). Complete pain relief was observed in 4 (8%) patients total, 2 in each group. There were no long-term complications. Limitations: Single-blinded study. Conclusion: There were no differences in onset or duration of pain relief when either 1 or 2 injections were used. There was no difference in safety or survival between the 2 groups. (Clinical trial registration number: NCT00583479.)

Original languageEnglish
Pages (from-to)1300-1307
Number of pages8
JournalGastrointestinal Endoscopy
Volume74
Issue number6
DOIs
StatePublished - Dec 2011

Fingerprint

Celiac Plexus
Pancreatic Neoplasms
Prospective Studies
Injections
Pain
Alcohols
Safety
Survival
Bupivacaine
Telephone
Tertiary Care Centers
Abdomen

ASJC Scopus subject areas

  • Gastroenterology
  • Radiology Nuclear Medicine and imaging

Cite this

A prospective, randomized study of EUS-guided celiac plexus neurolysis for pancreatic cancer : One injection or two? / Leblanc, Julia K.; Al-Haddad, Mohammad; McHenry, Lee; Sherman, Stuart; Juan, Michelle; McGreevy, Kathleen; Johnson, Cynthia; Howard, Thomas; Lillemoe, Keith D.; DeWitt, John.

In: Gastrointestinal Endoscopy, Vol. 74, No. 6, 12.2011, p. 1300-1307.

Research output: Contribution to journalArticle

Leblanc, Julia K. ; Al-Haddad, Mohammad ; McHenry, Lee ; Sherman, Stuart ; Juan, Michelle ; McGreevy, Kathleen ; Johnson, Cynthia ; Howard, Thomas ; Lillemoe, Keith D. ; DeWitt, John. / A prospective, randomized study of EUS-guided celiac plexus neurolysis for pancreatic cancer : One injection or two?. In: Gastrointestinal Endoscopy. 2011 ; Vol. 74, No. 6. pp. 1300-1307.
@article{b8ad9abbc5ea42e2a6219238e8f9b565,
title = "A prospective, randomized study of EUS-guided celiac plexus neurolysis for pancreatic cancer: One injection or two?",
abstract = "Background: The technique of alcohol injection during EUS-guided celiac plexus neurolysis (CPN) in patients with pancreatic cancerrelated pain has not been standardized. Objective: To compare pain relief and safety of alcohol given as 1 versus 2 injections during EUS-guided CPN (EUS-CPN). Secondary outcomes examined were characteristics that predict response and survival. Design: Single-blinded, prospective, randomized, parallel-group study. Setting: Tertiary-care center. Patients: This study involved patients with pancreatic cancerrelated pain. Intervention: EUS-CPN done by injecting 20 mL of 0.75{\%} bupivacaine and 10 mL 98{\%} alcohol into 1 or 2 sites at the celiac trunk. Participants were interviewed by telephone at 24 hours and weekly thereafter. Main Outcome Measurements: Time until onset of pain relief, duration of pain relief, complications. Results: Fifty patients (mean age 63 years; 24 men) were enrolled and randomized (29 in 1-injection, 21 in 2-injections groups). Pain relief was observed in 37 (74{\%}) patients: 20 (69{\%}) in the 1-injection group and 17 (81{\%}) in the 2-injection group (chi-square P =.340). Median onset of pain relief was 1 day for both 1-injection (range 1-28 days) and 2-injection (range 1-21 days) groups (Mann-Whitney P =.943). Median duration of pain relief in the 1-injection and 2-injection groups was 11 weeks and 14 weeks, respectively (log-rank P =.612). Complete pain relief was observed in 4 (8{\%}) patients total, 2 in each group. There were no long-term complications. Limitations: Single-blinded study. Conclusion: There were no differences in onset or duration of pain relief when either 1 or 2 injections were used. There was no difference in safety or survival between the 2 groups. (Clinical trial registration number: NCT00583479.)",
author = "Leblanc, {Julia K.} and Mohammad Al-Haddad and Lee McHenry and Stuart Sherman and Michelle Juan and Kathleen McGreevy and Cynthia Johnson and Thomas Howard and Lillemoe, {Keith D.} and John DeWitt",
year = "2011",
month = "12",
doi = "10.1016/j.gie.2011.07.073",
language = "English",
volume = "74",
pages = "1300--1307",
journal = "Gastrointestinal Endoscopy",
issn = "0016-5107",
publisher = "Mosby Inc.",
number = "6",

}

TY - JOUR

T1 - A prospective, randomized study of EUS-guided celiac plexus neurolysis for pancreatic cancer

T2 - One injection or two?

AU - Leblanc, Julia K.

AU - Al-Haddad, Mohammad

AU - McHenry, Lee

AU - Sherman, Stuart

AU - Juan, Michelle

AU - McGreevy, Kathleen

AU - Johnson, Cynthia

AU - Howard, Thomas

AU - Lillemoe, Keith D.

AU - DeWitt, John

PY - 2011/12

Y1 - 2011/12

N2 - Background: The technique of alcohol injection during EUS-guided celiac plexus neurolysis (CPN) in patients with pancreatic cancerrelated pain has not been standardized. Objective: To compare pain relief and safety of alcohol given as 1 versus 2 injections during EUS-guided CPN (EUS-CPN). Secondary outcomes examined were characteristics that predict response and survival. Design: Single-blinded, prospective, randomized, parallel-group study. Setting: Tertiary-care center. Patients: This study involved patients with pancreatic cancerrelated pain. Intervention: EUS-CPN done by injecting 20 mL of 0.75% bupivacaine and 10 mL 98% alcohol into 1 or 2 sites at the celiac trunk. Participants were interviewed by telephone at 24 hours and weekly thereafter. Main Outcome Measurements: Time until onset of pain relief, duration of pain relief, complications. Results: Fifty patients (mean age 63 years; 24 men) were enrolled and randomized (29 in 1-injection, 21 in 2-injections groups). Pain relief was observed in 37 (74%) patients: 20 (69%) in the 1-injection group and 17 (81%) in the 2-injection group (chi-square P =.340). Median onset of pain relief was 1 day for both 1-injection (range 1-28 days) and 2-injection (range 1-21 days) groups (Mann-Whitney P =.943). Median duration of pain relief in the 1-injection and 2-injection groups was 11 weeks and 14 weeks, respectively (log-rank P =.612). Complete pain relief was observed in 4 (8%) patients total, 2 in each group. There were no long-term complications. Limitations: Single-blinded study. Conclusion: There were no differences in onset or duration of pain relief when either 1 or 2 injections were used. There was no difference in safety or survival between the 2 groups. (Clinical trial registration number: NCT00583479.)

AB - Background: The technique of alcohol injection during EUS-guided celiac plexus neurolysis (CPN) in patients with pancreatic cancerrelated pain has not been standardized. Objective: To compare pain relief and safety of alcohol given as 1 versus 2 injections during EUS-guided CPN (EUS-CPN). Secondary outcomes examined were characteristics that predict response and survival. Design: Single-blinded, prospective, randomized, parallel-group study. Setting: Tertiary-care center. Patients: This study involved patients with pancreatic cancerrelated pain. Intervention: EUS-CPN done by injecting 20 mL of 0.75% bupivacaine and 10 mL 98% alcohol into 1 or 2 sites at the celiac trunk. Participants were interviewed by telephone at 24 hours and weekly thereafter. Main Outcome Measurements: Time until onset of pain relief, duration of pain relief, complications. Results: Fifty patients (mean age 63 years; 24 men) were enrolled and randomized (29 in 1-injection, 21 in 2-injections groups). Pain relief was observed in 37 (74%) patients: 20 (69%) in the 1-injection group and 17 (81%) in the 2-injection group (chi-square P =.340). Median onset of pain relief was 1 day for both 1-injection (range 1-28 days) and 2-injection (range 1-21 days) groups (Mann-Whitney P =.943). Median duration of pain relief in the 1-injection and 2-injection groups was 11 weeks and 14 weeks, respectively (log-rank P =.612). Complete pain relief was observed in 4 (8%) patients total, 2 in each group. There were no long-term complications. Limitations: Single-blinded study. Conclusion: There were no differences in onset or duration of pain relief when either 1 or 2 injections were used. There was no difference in safety or survival between the 2 groups. (Clinical trial registration number: NCT00583479.)

UR - http://www.scopus.com/inward/record.url?scp=82755188234&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=82755188234&partnerID=8YFLogxK

U2 - 10.1016/j.gie.2011.07.073

DO - 10.1016/j.gie.2011.07.073

M3 - Article

C2 - 22000795

AN - SCOPUS:82755188234

VL - 74

SP - 1300

EP - 1307

JO - Gastrointestinal Endoscopy

JF - Gastrointestinal Endoscopy

SN - 0016-5107

IS - 6

ER -