Abstract
Background and Aims:This study aimed for a comparative evaluation of transaortic coeliac plexus rhizolysis with bilateral splanchnic nerve radio frequency ablation for decrease in visual analogue scale(VAS) score and oral morphine requirements, in patients having upper gastrointestinal (GI) malignancies with intractable pain.Methods:Patients were randomly allocated in two group of 30 eackGroup 1 received bilateral splanchnic nerve radio-frequency ablation(SRF group) and group 2 had trans-aortic coeliac plexus rhizolysis (CPR group). Study was conducted over a period of 18 months. Following data were collected:VAS score, oral morphine requirement , adverse effects, and improvement in the quality of life.Results:Total of 33 patients (17 in SRF and 16 in CPR group) completed full 6 months follow-up Other patients were followed up until their demise. At the end of 6 months VAS score was reduced to 2.13±1.48 (cm) and 3.28±1.4 (cm) in SRF and CPR groups respectively and mean morphine consumption was 13.4 ± 15.3 mg/day and 26.11 ± 23.5 mg/day in SRF group and CPR group respectively..Conclusion:In upper GI cancer patients with severe intractable abdominal pain, interventional approach along with pharmacological management provides better analgesic efficacy . Both the techniques (bilateral splanchnic nerve RFA and trans-aortic coeliac plexus rhizolysis) were effective for the relief of severe intractable abdominal pain in upper GI malignancies.
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