Background: Abdominal and back pain is present in up to 80% of patients with pancreatic cancer and represents a significant cause of morbidity. Celiac plexus neurolysis (CPN) demonstrated good results in relief of pain of upper abdominal malignancy. Dexmedetomidine is alpha-2 adrenoceptor highly selective agonist approved for procedural sedation use.
Patients And Methods: Fifty patients divided in two groups with locally advanced pancreatic cancer-associated abdominal pain underwent endoscopic ultrasound (EUS)-guided CPN using bupivacaine 0.5% alone with alcohol for the first group and bupivacaine 0.5% plus dexmedetomidine in the second. Patients scored their pain according to the Numeric Rating Scale (NRS-11) before, 2, 4, 6, 8, 12, 16, and 24 week after the procedure.
Results: The study has included 50 patient in two groups. There was no significant difference between the two groups as regards medical, laboratory, or tumor characters. The median pain score decreases from 8.32 ± 0.75 before the procedure to 3.75 ± 3.72 24 week after the procedure in group 1 and from 8.08 ± 0.86 before to 1.67 ± 2.3 24 week after the procedure in group 2. However, there was no significant difference between the two groups in the median pain score during the first 4 weeks. There was no statistically significant difference between the two groups as regards the median survival time.
Conclusion: The addition of dexmedetomidine to bupivacaine 0.5% in EUS-CPN demonstrated beneficial effects as regards the degree and duration of pain relieve with negligible effect on the patient survival.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1007/s12029-020-00449-1 | DOI Listing |
Cureus
December 2024
Department of Anaesthesiology and Critical Care, Pacific Medical College and Hospital, Udaipur, IND.
Background Due to its affordability and ease of application, the subarachnoid block is the most frequently used method for lower abdominal procedures. Levobupivacaine has an onset of sensory and motor blockade comparable to that of bupivacaine and prolongs the duration of analgesia while facilitating quick recovery from motor block. Fentanyl and dexmedetomidine, when used as additives to intrathecal local anesthetic, can extend the duration of sensory and motor blockade and enhance postoperative analgesia.
View Article and Find Full Text PDFJ Pain Res
January 2025
Department of Pain Management, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China.
Background: Scalp nerve blocks (SNB) may significantly reduce post-craniotomy pain (PCP) but only for a short period of time. Dexamethasone, as an adjuvant to local anesthetics, was reported to prolong the analgesia duration of never block; however, the addition of dexamethasone to SNB is rare. We therefore tested the hypothesis that dexamethasone as an adjuvant to bupivacaine in SNB is positive after craniotomy.
View Article and Find Full Text PDFAgri
January 2025
Department of Anesthesiology and Reanimation, Yozgat City Hospital, Yozgat, Türkiye.
Objectives: Lateral sagittal infraclavicular approach is frequently used because it has less risk of complications and provides rapid and adequate regional anesthesia. Due to the fact that the brachial plexus is deeper in the infraclavicular region and the approach angle is sharper, it can be technically challenging. In this study, we aimed to compare the costoclavicular approach, which is a newly defined approach, with the lateral sagittal infraclavicular brachial plexus block.
View Article and Find Full Text PDFAgri
January 2025
Department of Anesthesiology and Reanimation, İstanbul Medipol University Faculty of Medicine, İstanbul, Türkiye.
Objectives: Breast-conserving surgery is a common breast operation type in the world. Patients may feel severe postoperative pain after the surgery. Several regional anesthesia methods are used for postoperative pain control as a part of multimodal analgesia management after breast surgery.
View Article and Find Full Text PDFCurr Drug Saf
January 2025
Anesthesiology, Surgical Intensive Care and Pain Medicine Department, Faculty of Medicine, Kafr-El Sheikh University, Kafr-El Sheikh, Egypt.
Background: For surgical procedures of the upper limbs, ultrasound-guided supraclavicular brachial plexus block (SCBPB) represents a safe substitute for general anesthesia. The present study evaluated the effectiveness and safety of incorporating 1μg/kg dexmedetomidine (DEX) into 20 ml bupivacaine, as opposed to using 20 ml and 30 ml bupivacaine without additives, in SCBPB.
Methods: This randomized, controlled, double-blind study included 75 patients assigned to elective upper-limb surgery under the mid-humerus level.
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!