Management of Chronic Upper Abdominal Pain in Cancer

Plancarte, Ricardo; Guajardo-Rosas, Jorge; Reyes-Chiquete, David; Chejne-Gómez, Faride; Plancarte, Andrea; González-Buendía, Nadia I.; Cerezo-Camacho, Oscar; Lee, Ángel; Medina-Santillán, Roberto

doi:10.1097/aap.0b013e3181fa6b42

Cited by 30 publications

(21 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Of the 68 articles, 14 full-text articles were eligible for this review. [ 9 11 14 15 16 17 18 19 20 21 22 23 24 25 ] Quantitative analysis involved ten articles. [ 9 11 15 17 18 19 20 23 24 25 ] Among the studies included, there were four RCTs,[ 14 15 16 17 ] three non-RCT prospective studies,[ 17 18 19 ] and seven retrospective cohort studies.…”

Section: Resultsmentioning

confidence: 99%

“…[ 9 11 14 15 16 17 18 19 20 21 22 23 24 25 ] Quantitative analysis involved ten articles. [ 9 11 15 17 18 19 20 23 24 25 ] Among the studies included, there were four RCTs,[ 14 15 16 17 ] three non-RCT prospective studies,[ 17 18 19 ] and seven retrospective cohort studies. [ 9 11 21 22 23 24 25 ] This review included a total of 725 patients who met our inclusion criteria.…”

Section: Resultsmentioning

confidence: 99%

“…The study characteristics have been summarised in Tables 2 and 3 . [ 9 11 14 15 16 17 18 19 20 21 22 23 24 25 ] We employed plotDigitizer ( https://plotdigitizer.com/app )[ 13 ] to extract raw data from the images provided in the study by Chen et al . [ 19 ]…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Efficacy of splanchnic nerve neurolysis in the management of upper abdominal cancer pain: A systematic review and meta-analysis

Goyal,

Kumar,

Goyal

et al. 2023

Indian Journal of Anaesthesia

View full text Add to dashboard Cite

Background and Aims: Neurolytic splanchnic nerve block (NSNB) is practised in intractable abdominal pain secondary to intra-abdominal malignancies. This review evaluated the efficacy of NSNB. Methods: PubMed, Embase, Scopus, and Cochrane databases were searched for articles published from January 2001 to October 2023. Two independent reviewers extracted the data from the included studies. The quality of randomised controlled trials (RCTs) was assessed using the revised Cochrane risk-of-bias tool (RoB 2), and the Newcastle–Ottawa scale was used for cohort studies. Results: Fourteen articles (4 RCTs, 3 non-randomised prospective, and 7 retrospectives) were included. Ten articles were quantitatively assessed and demonstrated significant pain relief at 1 week (standardised mean difference (SMD): 3.46 [2.09, 4.83], P < 0.001, I2 = 95%), 2 weeks (SMD: 4.45 [2.61, 6.29], P < 0.001, I2 = 95%), 4 weeks (SMD: 3.35 [2.23, 4.47], P < 0.001, I2 = 97%), 8 weeks (SMD: 3.7 [2.71, 4.7], P < 0.001, I2 = 86%), 12 weeks (SMD: 4.01 [2.66, 5.36], P < 0.001, I2 = 95%), and 24 weeks (SMD: 2.54 [1.71,3.37], P < 0.001, I2 = 84%). Daily narcotic consumption and quality of life (QOL) significantly improved post neurolysis, but survival rates showed controversial results. Significant heterogeneity was reported, and sub-group analysis revealed a moderate level of variability [I2 = 47.3%] pertaining to study design as a source of heterogeneity. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) Pro GDT recommendation for the primary objective was ‘high’ for the analysis of RCTs and ‘very low’ evidence quality for observational studies. Only transient minor complications were reported. Conclusion: NSNB appears to be an efficacious technique that provides substantial pain relief, reduces opioid consumption, and ameliorates QOL.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Efficacy of splanchnic nerve neurolysis in the management of upper abdominal cancer pain: A systematic review and meta-analysis

Goyal,

Kumar,

Goyal

et al. 2023

Indian Journal of Anaesthesia

View full text Add to dashboard Cite

show abstract

“…Nörolitik bloklar ve lokal anesteziklerin de eklenmesiyle epidural/int-ratekal kateter/port/pompa sistemleri kullanılarak opioid dozlarında anlamlı azalma ile birlikte daha iyi analjezik etkinlik ve daha iyi yaşam kalitesi sağlana-bilmektedir. [22][23][24][25][26][27] Literatürde kanser hastalarına %8-11 oranında invazif girişim gereksinimi olabileceği, ancak uygun girişimlerin yapılabileceği merkezlerin olmaması veya hastaların bu merkezlere yönlendiril-mesinde çok geç kalındığı bildirilmektedir. [28,29] Terminal dönem kanser hastalarında farmakolojik ve invazif girişimlerin yanısıra ağrı palyasyonunda etkinliği gösterilmiş rehabilitasyon, [30][31][32] psikososyal, [33,34] ve manevi destek [35] gibi tamamlayıcı tedaviler de kullanılmalıdır.…”

Section: Discussionunclassified

The Management of Pain and Opioid Use for Cancer Patients at Palliative Care Clinic

Şenel¹

2016

Agri

View full text Add to dashboard Cite

ÖzetAmaç: Ağrı, palyatif bakım kliniklerinde kanser hastalarının yaşam kalitesini belirgin olarak etkileyen önemli semptomlardan biridir. Gelişmekte olan ülkelerde opioidlere ulaşılabilirlikteki güçlükler ve iyi organize edilmiş palyatif bakım merkezlerinin azlığı ağrı tedavisinin yetersiz olmasına neden olmaktadır.Türkiye, kişi başına düşen opioid tüketiminin istatistiksel olarak yetersiz olduğu ülkelerden biridir. 2010 yılında kişi başına düşen opioid miktarı 14.31 mg morfin eşdeğeri olup, opioid analjezik tüke-timinin yeterliliği %7 olarak bulunmuştur. Bu çalışmada palyatif bakım kliniğinde yatan hastalarda opioid kullanımı araştırıldı. Gereç ve Yöntem: 2014 yılında, palyatif bakım kliniğimizde palyatif bakım verilen 418 kanser hastasının verileri retrospektif olarak değerlendirildi. Bulgular: Hastaların 183'ü (%44) kadın, 235'i (%56) erkek olarak bulundu. Yaşlar 18 ve 93 yıl arasında değişmekteydi (61±15). Hastaların %9'una opioid verilmemişti, %26'sı zayıf opioid, %65'i güçlü opioid kullanmaktaydı. Hasta başına düşen günlük oral morfin eşdeğer dozu 172±58 mg (40-328) olarak bulundu. Opioid kullanımı için endikasyonlar %61 oranında ağrı, %19 oranında dispne ve %20 oranında ise hem dispne hem de ağrıydı. Sonuç: Ülkemizde opioid çeşitleri kısıtlı olmakla beraber tüm sağlık personelinin ağrı tedavisi ve opioid kullanımı hakkında eğitimi ile daha etkin ve yeterli ağrı tedavisi sağlanabileceği düşünüldü. Rölatif olarak zayıf opioidlerin yüksek kullanım insidansı, ülkemizde hızlı salınımlı opioidlerin eksikliğiyle ilişkili olabilir.Anahtar sözcükler: Ağrı; kanser hastası; opioid; palyatif bakım. SummaryObjectives: Pain is one of the most important symptoms in palliative care, and has a major impact on the quality of life of cancer patients. In developing countries, difficult access to opioids and the lack of well-established palliative care organizations result in undertreatment of pain. Turkey is one of the countries with statistical evidence of inadequate morphine consumption per capita. In 2010, the adequacy of opioid analgesic consumption was only 7%, based on a per capita consumption of 14.31 mg morphine equivalents. The present study analyzed and described patterns of opioid use among cancer patients in the palliative care clinic. Methods: The data of 418 cancer patients who received palliative care at the palliative care clinic in 2014 were evaluated retrospectively. Results: Of the total, 183 (44%) of the patients studied were female and 235 (56%) were male. Age ranged from 18 to 93 years (61±15 years). No opioids had been prescribed for 9% of patients, 26% of patients were using weak opioids, and 65% were using strong opioids. Daily oral morphine equivalent dosage per patient was 172±58 mg (range: 40-328 mg). Indications for opioid use were pain (61%), dyspnea (19%), and both dyspnea and pain (20%). Conclusion: Although there is a limited variety of opioids currently available in this country, it is thought that a more effective and adequate level of pain management can be obtained through education of he...

show abstract

“…Another sympathetic neurolytic block is that of the ganglion impair, the terminal bit of the sympathetic chain. It is used for the treatment of pain originating from the prostatic or rectal cancer ( 24 ).…”

Section: Pharmacological Management Of Cancer Painmentioning

confidence: 99%

Anaesthetic challenges in cancer patients: current therapies and pain management

Gudaitytė¹,

Dvylys²,

Šimeliūnaitė³

2017

AML

View full text Add to dashboard Cite

The objective.The aim is to present the major effects of cancer treatment (chemotherapy, radiotherapy, surgery) that the anaesthesiologist should consider preoperatively, and to review techniques of the analgesic management of the disease.Materials and Methods.To summarize the major challenges that cancer patients present for the anaesthesiologists, a literature review was conducted. Articles presenting evidence or reviewing the possible effects of anaesthetics on cancer cells were also included. Online databases of Science Direct, PubMed, and ELSEVIER, as well as reference lists of included studies were searched. Articles published from 2005 to 2016 were selected.Results.Anaesthesiologists should pay attention to patients receiving chemotherapy and its side effects on organ systems. Bleomycin causes pulmonary damage, anthracyclines are cardiotoxic, and platinum-based chemotherapy agents are nephrotoxic. A lot of chemotherapy agents lead to abnormal liver function, vomiting, diarrhoea, etc. Surgery itself is suspected to be associated with an increased risk of metastasis and recurrence of cancer. Regional anaesthesia and general anaesthesia with propofol should be used and volatile agents should be avoided to prevent cancer patients from perioperative immunosuppression that leads to increased risk of cancer recurrence. Pain management for palliative patients remains a major problem.Conclusions.To provide the best treatment for cancer patients, cooperation of anaesthesiologists with oncologists and surgeons becomes imperative. It has been established that anaesthetic techniques and drugs could minimize the perioperative inflammation. However, further research of the perioperative “onco-anaesthetic” is needed.

show abstract

Management of Chronic Upper Abdominal Pain in Cancer

Cited by 30 publications

References 31 publications

Efficacy of splanchnic nerve neurolysis in the management of upper abdominal cancer pain: A systematic review and meta-analysis

Efficacy of splanchnic nerve neurolysis in the management of upper abdominal cancer pain: A systematic review and meta-analysis

The Management of Pain and Opioid Use for Cancer Patients at Palliative Care Clinic

Anaesthetic challenges in cancer patients: current therapies and pain management

Contact Info

Product

Resources

About