Abstract
OBJECTIVE: To evaluate the effectiveness and safety of CT/ultrasound dual-modality guided posterior approach in the management of upper abdominal cancer pain. STUDY DESIGN: Clinical research study. METHODS: A total of 19 patients (7 men and 12 women) who had advanced carcinomatous epigastric pain and match the selection criteria were recruited in this study. All the patients proceed the bilateral Splanchnic Nerve Neurolysis (SNN) under Computed Tomography (CT) guided and Ultrasound. The pain Numerical Rating Scale (NRS) at different times (T0: preprocedure, T1: 1 day after-procedure, T2: 1 weeks, T3 and T4: 4 and 8 weeks after-procedure and drug taken dosages were recorded. The incidence of complications was also assessed. RESULTS: All the patients were successfully completed procedures under CT/Ultrasound dual-guided. NRS exhibited significant differences when comparing the preoperative time point (T0) with each of the following time intervals (T1-T4) (***P < 0.001). As the NRS gradually decreased, significant differences were observed between T2 and T3 (**P < 0.05). However, no significant difference was found between T3 and T4 regarding pain scores (p = 0.331). The consumption of morphine was significantly lower postoperatively than preoperatively, with the most pronounced reduction observed on the first day after surgery (***P < 0.001). Nevertheless, no statistically significant differences were observed at the other time intervals (P > 0.05). No severe complications during or after the surgery. Two patients (10.5%) felt burning pain in the abdomen for 2 days, 1 patient had transient backache for 3 days, and 12 (63.2%) patients had diarrhea for 1 week and disappear. CONCLUSION: The CT/Ultrasound dual-guided SNN procedure is regarded as a efficacy and safety treatment for managing abdominal cancer pain. It increases constant visualization in the operation and reduces radiation exposure.