Splanchnic nerve block via transdiscal and paraspinal approach in the treatment of pain in advanced pancreatic cancer: A randomized controlled trial.

BACKGROUND

This randomized controlled clinical trial aims to assess the clinical effect of splanchnic nerve block through transdiscal and paraspinal approaches in treating pain from advanced pancreatic cancer.

METHODS

Patients with progressive pancreatic cancer pain who were treated in the Pain Department of the First Affiliated Hospital of Nanchang University from December 2021 to March 2023 were selected. According to the inclusion and exclusion criteria, 34 patients were randomly divided into a transdiscal group (n = 17) and a paraspinal group (n = 17). The patient's intraoperative puncture time and the number of digital subtraction angiography fluoroscopy exposures were recorded. The Visual Analogue Scale (VAS), patient satisfaction scale, Karnofsky score, morphine consumption, and occurrence of adverse events were recorded preoperatively and 1 day, 3 days, 1 week, 1 month, and 3 months after surgery.

RESULTS

A total of 14 patients were followed up in the transdiscal group, and 15 patients were followed up in the paraspinal group. There was no significant difference in the general condition between the 2 groups before the operation. The puncture time and number of fluoroscopies in the transdiscal group were significantly less than in the paraspinal group (P < .001). There was no significant difference in VAS, patient satisfaction scale, or Karnofsky score between the 2 groups at each postoperative time point. In the same group, the VAS scores at each time point after operation were significantly lower than those before operation (P < .001). The 2 groups had no significant difference in the total incidence of complications.

CONCLUSION

Splanchnic nerve block paraspinal had a significant effect on the treatment of advanced pain in pancreatic cancer patients. However, transdiscal is equally effective, the positioning is more accurate, the operation is simpler, and it is a better choice.