{"title":"上消化道癌症患者经椎间盘与经皮质腹腔丛神经阻滞的比较研究。一项前瞻性随机对照研究","authors":"A. Rath, Reena, A. Paswan, M. Tewari","doi":"10.56126/72.3.3","DOIUrl":null,"url":null,"abstract":"Aim: To compare transdiscal and transaortic techniques of neurolytic celiac plexus block for upper gastrointestinal cancer patients.\n\nMethods: In this prospective randomized study 60 patients with upper gastrointestinal malignancies were included and randomly divided into two groups, group TD and group TA, receiving neurolytic celiac plexus blocks via transdiscal and transaortic techniques, respectively. The primary outcome was quality of life (QoL) as assessed by WHOQOL BREF questionnaire and secondary outcomes were pain relief using visual analogue scale (VAS), and occurrence of complications like hypotension, loose motion, bleeding and discitis.\n\nResult: QoL and VAS score were significantly improved in both groups post procedure. Transdiscal approach is more effective in improving VAS score than transaortic approach (1 vs 3) after 1 week and the relief of pain was better in TD group (3 vs 6) at the end of 2 months. Transdiscal approach was found to be more effective in improving QoL (227.00±28.85 vs 191.17±35.78) as compared to transaortic approach. However, post-procedural QoL improved in both groups when compared to pre-procedural QoL (p<0.05). Hypotension, diarrhea and bleeding from aorta were higher in TA group; however, no serious complications were seen in any of the groups.\n\nConclusion: Transdiscal technique is better in terms of adequate pain relief and improving QoL as compared to transaortic technique of NCPB in patients of upper GI malignancies and is associated with lesser incidences of complications.","PeriodicalId":7024,"journal":{"name":"Acta anaesthesiologica Belgica","volume":null,"pages":null},"PeriodicalIF":0.1000,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A comparative study of transdiscal versus transaortic celiac plexus neurolytic block for upper gastrointestinal cancer patients. A prospective, randomized control study\",\"authors\":\"A. Rath, Reena, A. Paswan, M. Tewari\",\"doi\":\"10.56126/72.3.3\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Aim: To compare transdiscal and transaortic techniques of neurolytic celiac plexus block for upper gastrointestinal cancer patients.\\n\\nMethods: In this prospective randomized study 60 patients with upper gastrointestinal malignancies were included and randomly divided into two groups, group TD and group TA, receiving neurolytic celiac plexus blocks via transdiscal and transaortic techniques, respectively. The primary outcome was quality of life (QoL) as assessed by WHOQOL BREF questionnaire and secondary outcomes were pain relief using visual analogue scale (VAS), and occurrence of complications like hypotension, loose motion, bleeding and discitis.\\n\\nResult: QoL and VAS score were significantly improved in both groups post procedure. Transdiscal approach is more effective in improving VAS score than transaortic approach (1 vs 3) after 1 week and the relief of pain was better in TD group (3 vs 6) at the end of 2 months. Transdiscal approach was found to be more effective in improving QoL (227.00±28.85 vs 191.17±35.78) as compared to transaortic approach. However, post-procedural QoL improved in both groups when compared to pre-procedural QoL (p<0.05). Hypotension, diarrhea and bleeding from aorta were higher in TA group; however, no serious complications were seen in any of the groups.\\n\\nConclusion: Transdiscal technique is better in terms of adequate pain relief and improving QoL as compared to transaortic technique of NCPB in patients of upper GI malignancies and is associated with lesser incidences of complications.\",\"PeriodicalId\":7024,\"journal\":{\"name\":\"Acta anaesthesiologica Belgica\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.1000,\"publicationDate\":\"2021-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Acta anaesthesiologica Belgica\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.56126/72.3.3\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"ANESTHESIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta anaesthesiologica Belgica","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.56126/72.3.3","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的:比较上消化道癌症患者腹腔神经丛阻滞的经椎间盘和经皮质技术。方法:在这项前瞻性随机研究中,60名上消化道恶性肿瘤患者被纳入并随机分为两组,TD组和TA组,分别通过经椎间和经皮质技术接受腹腔神经丛阻滞。主要结果是通过WHOQOL BREF问卷评估的生活质量(QoL),次要结果是使用视觉模拟量表(VAS)缓解疼痛,以及低血压、松动、出血和椎间盘炎等并发症的发生。结果:两组患者术后生活质量和VAS评分均有明显改善。1周后,经椎间盘入路在改善VAS评分方面比经皮质入路(1比3)更有效,并且在2个月结束时,TD组的疼痛缓解效果更好(3比6)。与经皮质入路相比,经椎间盘入路在改善生活质量方面更有效(227.00±28.85 vs 191.17±35.78)。但与术前相比,两组术后生活质量均有改善(p<0.05)。TA组低血压、腹泻和主动脉出血率较高;然而,在任何一组中都没有发现严重的并发症。结论:在上消化道恶性肿瘤患者中,与经皮质NCPB技术相比,经椎间盘技术在充分缓解疼痛和改善生活质量方面更好,并且并发症发生率更低。
A comparative study of transdiscal versus transaortic celiac plexus neurolytic block for upper gastrointestinal cancer patients. A prospective, randomized control study
Aim: To compare transdiscal and transaortic techniques of neurolytic celiac plexus block for upper gastrointestinal cancer patients.
Methods: In this prospective randomized study 60 patients with upper gastrointestinal malignancies were included and randomly divided into two groups, group TD and group TA, receiving neurolytic celiac plexus blocks via transdiscal and transaortic techniques, respectively. The primary outcome was quality of life (QoL) as assessed by WHOQOL BREF questionnaire and secondary outcomes were pain relief using visual analogue scale (VAS), and occurrence of complications like hypotension, loose motion, bleeding and discitis.
Result: QoL and VAS score were significantly improved in both groups post procedure. Transdiscal approach is more effective in improving VAS score than transaortic approach (1 vs 3) after 1 week and the relief of pain was better in TD group (3 vs 6) at the end of 2 months. Transdiscal approach was found to be more effective in improving QoL (227.00±28.85 vs 191.17±35.78) as compared to transaortic approach. However, post-procedural QoL improved in both groups when compared to pre-procedural QoL (p<0.05). Hypotension, diarrhea and bleeding from aorta were higher in TA group; however, no serious complications were seen in any of the groups.
Conclusion: Transdiscal technique is better in terms of adequate pain relief and improving QoL as compared to transaortic technique of NCPB in patients of upper GI malignancies and is associated with lesser incidences of complications.
期刊介绍:
L’Acta Anaesthesiologica Belgica est le journal de la SBAR, publié 4 fois par an. L’Acta a été publié pour la première fois en 1950. Depuis 1973 l’Acta est publié dans la langue Anglaise, ce qui a été résulté à un rayonnement plus internationaux. Depuis lors l’Acta est devenu un journal à ne pas manquer dans le domaine d’Anesthésie Belge, offrant e.a. les textes du congrès annuel, les Research Meetings, … Vous en trouvez aussi les dates des Research Meetings, du congrès annuel et des autres réunions.