A prospective randomized trial of 1 versus 2 injections during EUS-guided celiac plexus block for chronic pancreatitis pain

Julia K. LeBlanc, John DeWitt, Cynthia Johnson, Wycliffe Okumu, Kathleen McGreevy, Michelle Symms, Lee McHenry, Stuart Sherman, Thomas Imperiale

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Background: The efficacy of 1-injection versus a 2-injections method of EUS-guided celiac plexus block (EUS-CPB) in patients with chronic pancreatitis is not known. Objective: To compare the clinical effectiveness and safety of EUS-CPB by using 1 versus 2 injections in patients with chronic pancreatitis and pain. The secondary aim is to identify factors that predict responsiveness. Design: A prospective randomized study. Interventions: EUS-CPB was performed by using bupivacaine and triamcinolone injected into 1 or 2 sites at the level of the celiac trunk during a single EUS-CPB procedure. Main Outcome Measurements: Duration of pain relief, onset of pain relief, and complications. Results: Fifty-one subjects were enrolled (23 received 1 injection, 28 received 2 injections). Pain relief, which lasted a mean of 51.3 days (median 28 days, range 1-203 days) was observed in 28 subjects (55%). Thirteen of 23 subjects who received 1 injection (56.5%) had relief from pain compared with 15 of 28 subjects who received 2 injections (53.6%) (P = .8). The median times to onset in the 1-injection and 2-injections groups were 21 and 14 days, respectively (P = .99). No correlation existed between duration of pain relief and time to onset of pain relief or onset within 24 hours. Age, sex, race, prior EUS-CPB, and smoking or alcohol history did not predict duration of pain relief. Limitation: Telephone interviewers were not blinded. Conclusions: There was no difference in duration of pain relief or onset of pain relief in subjects with chronic pancreatitis and pain when the same total amount of medication was delivered in 1 or 2 injections during a single EUS-CPB procedure. Both methods were safe.

Original languageEnglish
Pages (from-to)835-842
Number of pages8
JournalGastrointestinal Endoscopy
Volume69
Issue number4
DOIs
StatePublished - Apr 2009

Fingerprint

Celiac Plexus
Chronic Pancreatitis
Chronic Pain
Injections
Pain
Triamcinolone
Bupivacaine
Pain Measurement
Telephone
Abdomen
Smoking
History

ASJC Scopus subject areas

  • Gastroenterology
  • Radiology Nuclear Medicine and imaging

Cite this

A prospective randomized trial of 1 versus 2 injections during EUS-guided celiac plexus block for chronic pancreatitis pain. / LeBlanc, Julia K.; DeWitt, John; Johnson, Cynthia; Okumu, Wycliffe; McGreevy, Kathleen; Symms, Michelle; McHenry, Lee; Sherman, Stuart; Imperiale, Thomas.

In: Gastrointestinal Endoscopy, Vol. 69, No. 4, 04.2009, p. 835-842.

Research output: Contribution to journalArticle

@article{d66df329036f439f9b8dfa5c76a9f865,
title = "A prospective randomized trial of 1 versus 2 injections during EUS-guided celiac plexus block for chronic pancreatitis pain",
abstract = "Background: The efficacy of 1-injection versus a 2-injections method of EUS-guided celiac plexus block (EUS-CPB) in patients with chronic pancreatitis is not known. Objective: To compare the clinical effectiveness and safety of EUS-CPB by using 1 versus 2 injections in patients with chronic pancreatitis and pain. The secondary aim is to identify factors that predict responsiveness. Design: A prospective randomized study. Interventions: EUS-CPB was performed by using bupivacaine and triamcinolone injected into 1 or 2 sites at the level of the celiac trunk during a single EUS-CPB procedure. Main Outcome Measurements: Duration of pain relief, onset of pain relief, and complications. Results: Fifty-one subjects were enrolled (23 received 1 injection, 28 received 2 injections). Pain relief, which lasted a mean of 51.3 days (median 28 days, range 1-203 days) was observed in 28 subjects (55{\%}). Thirteen of 23 subjects who received 1 injection (56.5{\%}) had relief from pain compared with 15 of 28 subjects who received 2 injections (53.6{\%}) (P = .8). The median times to onset in the 1-injection and 2-injections groups were 21 and 14 days, respectively (P = .99). No correlation existed between duration of pain relief and time to onset of pain relief or onset within 24 hours. Age, sex, race, prior EUS-CPB, and smoking or alcohol history did not predict duration of pain relief. Limitation: Telephone interviewers were not blinded. Conclusions: There was no difference in duration of pain relief or onset of pain relief in subjects with chronic pancreatitis and pain when the same total amount of medication was delivered in 1 or 2 injections during a single EUS-CPB procedure. Both methods were safe.",
author = "LeBlanc, {Julia K.} and John DeWitt and Cynthia Johnson and Wycliffe Okumu and Kathleen McGreevy and Michelle Symms and Lee McHenry and Stuart Sherman and Thomas Imperiale",
year = "2009",
month = "4",
doi = "10.1016/j.gie.2008.05.071",
language = "English",
volume = "69",
pages = "835--842",
journal = "Gastrointestinal Endoscopy",
issn = "0016-5107",
publisher = "Mosby Inc.",
number = "4",

}

TY - JOUR

T1 - A prospective randomized trial of 1 versus 2 injections during EUS-guided celiac plexus block for chronic pancreatitis pain

AU - LeBlanc, Julia K.

AU - DeWitt, John

AU - Johnson, Cynthia

AU - Okumu, Wycliffe

AU - McGreevy, Kathleen

AU - Symms, Michelle

AU - McHenry, Lee

AU - Sherman, Stuart

AU - Imperiale, Thomas

PY - 2009/4

Y1 - 2009/4

N2 - Background: The efficacy of 1-injection versus a 2-injections method of EUS-guided celiac plexus block (EUS-CPB) in patients with chronic pancreatitis is not known. Objective: To compare the clinical effectiveness and safety of EUS-CPB by using 1 versus 2 injections in patients with chronic pancreatitis and pain. The secondary aim is to identify factors that predict responsiveness. Design: A prospective randomized study. Interventions: EUS-CPB was performed by using bupivacaine and triamcinolone injected into 1 or 2 sites at the level of the celiac trunk during a single EUS-CPB procedure. Main Outcome Measurements: Duration of pain relief, onset of pain relief, and complications. Results: Fifty-one subjects were enrolled (23 received 1 injection, 28 received 2 injections). Pain relief, which lasted a mean of 51.3 days (median 28 days, range 1-203 days) was observed in 28 subjects (55%). Thirteen of 23 subjects who received 1 injection (56.5%) had relief from pain compared with 15 of 28 subjects who received 2 injections (53.6%) (P = .8). The median times to onset in the 1-injection and 2-injections groups were 21 and 14 days, respectively (P = .99). No correlation existed between duration of pain relief and time to onset of pain relief or onset within 24 hours. Age, sex, race, prior EUS-CPB, and smoking or alcohol history did not predict duration of pain relief. Limitation: Telephone interviewers were not blinded. Conclusions: There was no difference in duration of pain relief or onset of pain relief in subjects with chronic pancreatitis and pain when the same total amount of medication was delivered in 1 or 2 injections during a single EUS-CPB procedure. Both methods were safe.

AB - Background: The efficacy of 1-injection versus a 2-injections method of EUS-guided celiac plexus block (EUS-CPB) in patients with chronic pancreatitis is not known. Objective: To compare the clinical effectiveness and safety of EUS-CPB by using 1 versus 2 injections in patients with chronic pancreatitis and pain. The secondary aim is to identify factors that predict responsiveness. Design: A prospective randomized study. Interventions: EUS-CPB was performed by using bupivacaine and triamcinolone injected into 1 or 2 sites at the level of the celiac trunk during a single EUS-CPB procedure. Main Outcome Measurements: Duration of pain relief, onset of pain relief, and complications. Results: Fifty-one subjects were enrolled (23 received 1 injection, 28 received 2 injections). Pain relief, which lasted a mean of 51.3 days (median 28 days, range 1-203 days) was observed in 28 subjects (55%). Thirteen of 23 subjects who received 1 injection (56.5%) had relief from pain compared with 15 of 28 subjects who received 2 injections (53.6%) (P = .8). The median times to onset in the 1-injection and 2-injections groups were 21 and 14 days, respectively (P = .99). No correlation existed between duration of pain relief and time to onset of pain relief or onset within 24 hours. Age, sex, race, prior EUS-CPB, and smoking or alcohol history did not predict duration of pain relief. Limitation: Telephone interviewers were not blinded. Conclusions: There was no difference in duration of pain relief or onset of pain relief in subjects with chronic pancreatitis and pain when the same total amount of medication was delivered in 1 or 2 injections during a single EUS-CPB procedure. Both methods were safe.

UR - http://www.scopus.com/inward/record.url?scp=62949196899&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=62949196899&partnerID=8YFLogxK

U2 - 10.1016/j.gie.2008.05.071

DO - 10.1016/j.gie.2008.05.071

M3 - Article

C2 - 19136101

AN - SCOPUS:62949196899

VL - 69

SP - 835

EP - 842

JO - Gastrointestinal Endoscopy

JF - Gastrointestinal Endoscopy

SN - 0016-5107

IS - 4

ER -