■使用局部麻醉剂和类固醇的内脏神经阻滞(SPN)用于缓解慢性胰腺炎的疼痛。然而,它不能提供持久的救济。我们假设使用70%的酒精将提供超过数月的足够镇痛。
■主要目的是找出使用70%酒精与SPN的镇痛功效。次要目标包括副作用的发生率,干预后镇痛消耗,通过自我报告的生活质量量表评估生活质量(QOL),并在1年随访期间重复阻滞。
■对过去4年接受双侧SPN治疗的所有慢性胰腺炎患者进行回顾性分析。
■SPN是通过后路后路入路进行的,患者采用文献中描述的俯卧位,使用C臂/透视引导下,双侧T12水平的23G×90mm脊柱穿刺针。数据是从疼痛诊所的操作手册和医疗记录中收集的。
■使用非参数Wilcoxon符号秩检验收集块前到块后VAS评分变化的定量数据。
■基线VAS,术后VAS,随访3个月时VAS评分分别为7.69±1.3、2.44±0.96和1.56±1.15。基线和术后即刻进行的VAS成对比较,基线,并且在3个月时发现VAS是高度显著的。
■透视引导的神经溶解SPN,酒精含量为70%,可明显缓解疼痛3个月以上。这也导致3个月QOL的改善。
UNASSIGNED: Splanchnic nerve block (SPN) with local anesthetic and steroid is used to relieve the pain of chronic pancreatitis. However, it does not provide long-lasting relief. We hypothesize that the use of 70% alcohol will give adequate analgesia for more than months.
UNASSIGNED: The primary objective was to find out the analgesic efficacy of the use of 70% alcohol with SPN. Secondary objectives included the incidence of side effects, analgesic consumption postintervention, quality of life (QOL) assessed via a self-reported quality of life scale, and repeat block during the 1-year follow-up period.
UNASSIGNED: Retrospective analysis of all patients with chronic pancreatitis who received bilateral SPN over the last 4 years.
UNASSIGNED: SPN was performed using the posterior retrocrural approach with the patient in the prone position as described in the literature using a 23 G × 90 mm spinal needle bilaterally at the level of T12 using C-arm/fluoroscopy guidance. Data were collected from the procedure book of the pain clinic and medical records.
UNASSIGNED: Quantitative data for change in pre- to post-block VAS score was collected using the non-parametric Wilcoxon signed ranks test.
UNASSIGNED: The baseline VAS, post-procedure VAS, and VAS at 3 months follow-up was 7.69 ± 1.3,2.44 ± 0.96 and 1.56 ± 1.15. A pairwise comparison of VAS performed between baseline and immediate post-procedure, baseline, and VAS at 3 months was found to be highly significant.
UNASSIGNED: Fluoroscopy-guided neurolytic SPN with 70% alcohol gives significant pain relief for more than 3 months. It also leads to improvement in 3 months QOL.