Table 1:
Characteristics of controlled clinical trials that compare CPB with conventional pharmacological treatment.
| AUTHOR | COMPARE | PATIENTS | MESUREMENT | TECHNIQUE | CONCLUSION |
|---|---|---|---|---|---|
| Wong et al. 2004 (EEUU) |
PER-CPB vs only pharmacological treatment | Pain due to PCa. Age 63 years +/- 11. Male 53% | Pain, quality of life, opioid use, opioid adverse effects | Posterior access, F-guide, 22G needle, Bu 0.5% 10 ml, Iopamidol 1-5 ml, OH 100% 10 ml | PER-CPB improves pain relief, without affecting quality of life, opioid adverse effects, or survival. |
| Jain et al. 2005 (India) |
PER-CPB vs only pharmacological treatment | Abdominal or back pain using morphine, PCa, and gallbladder. Age 48.6 vs 50.9 years. Male 50 vs 60% | Pain (VAS), quality of life, opioid use, Karnosfki | Posterior access, F-guide, 22G needle, lidocaine 1%, meglumine, OH 50% 20 ml | PER-CPB significantly reduced pain intensity, opioid requirement, and opioid-related adverse effects. Also improving quality of life and functionality. |
| Zhang et al. 2007 (China) |
PER-CPB vs only pharmacological treatment | Intractable pain due to PCa. Age 38-75 years. Male 62.5% | Pain (VAS), quality of life (appetite, sleep, communication), opioid use, complications | L1 posterior access, T-guide, 23G needle, 5 ml 1% lidocaine, 3 ml contrast, 20 ml 100% OH | PER-CPB is an effective and safe modality |
| Wyse et al. 2011 (Canada) |
Early EUS-CPB vs only pharmacological treatment | Inoperable PCa pain. Age 66.5 years +/- 9. Male 49% | Pain (Likert scale), morphine consumption, quality of life (DDQ-15), survival | 19G needle, F-guide, bilateral injection of Bu 0.5% 10 ml and OH 100% 20 ml | Early EUS-CPB reduces pain and can moderate morphine intake. It can be considered at the time of diagnosis. |
| Amr et al. 2013 (Egypt) |
Early PER-CPB vs initial pharmacological control | Severe pain due to inoperable PCa. Age 50 years +/- 11. Male 65% | Pain (VAS), duration of relief, quality of life (QLQ-C30), analgesic requirement, adverse effects | Transaortic access, T12-L1, F-guide, 22G needle, 1% lidocaine, 70% OH. Drugs: gabapentin, tramadol, acetaminophen, morphine sulphate, fentanyl patches | Pharmacologically controlling pain and then performing PER-CPB was shown to be more effective in relieving long-term pain, opioid use, and quality of life. |
| Gao et al. 2014 (China) |
PER-CPB vs only pharmacological treatment | Terminal pain due to PCa. Age 65 years +/- 10 | Pain (VAS), duration of pain, consumption of analgesics, quality of life (QLQ) | Celiac neurolysis, F-guide, Bu and ethanol | PER-CPB is an effective method that significantly reduces pain, for longer, less use of medications and improves quality of life. |
| Kanno et al. 2020 (Japan) |
EUS-CPB vs oxycodone and / or fentanyl | Pain due to PCa. Age 69 years +/- 10. Male 50% | Pain (VAS), quality of life, opioid use | Needle 22 or 25G, US-guide, Bu 0.25% 2-3 ml, solution 15-30 ml (iopaminol 5% + OH 99% 95%) | EUS-CPB did not show a significant difference in pain relief, quality of life or opioid use. |
PER-CPB: Percutaneous celiac plexus block, EUS-CPB: Endoscopic-ultrasound Celiac plexus block, PCa: Pancreas cancer, F: Fluoroscopic, T: Tomographic, US: Ultrasonographic, Bu: Bupivacaine; OH: Alcohol.