Comparative evaluation of different volumes of 70% alcohol in celiac plexus block for upper abdominal malignsancies.

Abstract

Context:Celiac plexus block (CPB) (is an effective way to reduce cancer-associated pain in upper abdominal malignancies.Aims:To evaluate the efficacy and safety of different volumes of 70% alcohol in CPB.Settings and Design:Prospective, randomized, controlled clinical study.Subjects and Methods:Thirty patients of carcinoma gall bladder were randomly divided into three groups (n = 10) to receive 20, 30, and 40 ml of 70% alcohol in CPB.Statistical Analysis Used:All the continuous data were assessed analysis of variance followed by post-hoc tests (Tukey's Honestly Significant Difference test). Ordinal data were compared using Kruskal–Wallis H-test followed by Mann–Whitney U-test. Categorical comparisons were performed using Chi-square test.Results:A significant difference in visual analog scale (VAS) score of Group I, Group I and Group III was observed from week 6 onward until the end of the study. At all these time intervals, VAS scores in Group I was higher than both Groups II and III during this time interval. VAS scores in Group III were significantly lower as compared to Group II from week 10 onward until the end of the study. As compared to baseline, at all the follow-up intervals, mean morphine requirement was significantly lower in Group II and Group III. A quality of life (QOL) score of Group III were higher as compared to Group I. Between Group II and Group III, significant difference was observed at week 16 only when Group III had a higher score as compared to Group II.Conclusions:VAS score, QOL, and reduction in morphine consumption were increased on increasing the volume of alcohol in CPB, 40 ml being most effective.