The Adverse Effect of Analgesics and Coeliac Plexus Block for the Relief of Pain in Carcinoma of Pancreas – A Prospective Observational Study

Abstract

Introduction: Pancreatic cancer is a formidable health problem with increasing incidence. Worldwide, over 200000 people die annually of pancreatic cancer Because of high fatality rates; pancreatic cancer incidence rates are almost equal to mortality rates. Pancreatic cancer is diagnosed late in the natural history of the disease, given the few early indicators of illness, and the lack of screening tests for this disease. Neurolytic celiac plexus block (NCPB) is commonly used to treat pain of upper abdominal cancer that fails to respond to narcotic analgesics. CPB refers to the temporary inhibition of the celiac plexus often achieved with a corticosteroid injection in patients with benign pancreatic diseases like chronic pancreatitis. Aim of the study: The aim of this study was to determine and compare the adverse effect of analgesics and coeliac plexus block in relieving pain in carcinoma of pancreas. Methods: This study was a randomized comparative study and was conducted in the Department of Anesthesia, Analgesia and Intensive Care Medicine of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh during the period from July, 2008 to June, 2009. A total number of 60 patients were enrolled in this study. All patients were divided into two groups- Group A (treated with NCPB) & Group B (treated with conventional analgesic drugs). Result: In total 60 patients from both the groups completed the study. In our study we found the majority (58%) of our patients were aged between 41-60 years old followed by 30% were aged above 60 years old. The least prevalence 5% &7% was found among <= 20 and 21-40 years old respectively. In this study we found majority of our patients were male (63%) compared to female (37%).The mean age in the group A and group B patients were 48.73 ± 14.26 years and 51.47 ± 12.35 years respectively. In our study we found after 15th day of treatment severe vomiting was 13% in group B on the other hand vomiting was absent in. 13% in group ........