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document
Bedside ultrasound-guided celiac plexus neurolysis in upper abdominal cancer patients : a randomized , prospective study for comparison of percutaneous bilateral paramedian vs. unilateral paramedian needle-insertion technique . INTRODUCTION Percutaneous anterior abdominal ultrasound guidance for performing celiac plexus neurolysis is a relatively new but more economical , less time-consuming , more comfortable bedside technique for interventional pain management . Paucity of studies evaluating the efficacy of single-site vs. double-site injections at celiac trunk for ultrasound-guided celiac plexus neurolysis ( USCPN ) prompted us to conduct a prospective , randomized , single-blind clinical trial to compare USCPN using bilateral paramedian ( double needle ) technique with unilateral paramedian ( single needle ) technique . METHODS Sixty patients aged 18 years or older with unresectable upper abdominal cancers were randomized into two groups to receive USCPN . A 20-mL mixture of 50 % ethanol with 0.25 % bupivacaine was injected either unilaterally ( 20 mL×1 site ) or bilaterally ( 10 mL×2 sites ) depending on the randomization group . Subjects were assessed for the pain relief using Numerical rating scale ( NRS ) to assess their pain relief . RESULTS Baseline parameters being comparable ( P > 0.05 ) , the site of drug injections ( single or double needle ) had no bearing on the onset of pain relief and patient satisfaction scores ( P > 0.05 ) . Pain relief during follow-up visits was comparable between the two groups ( P > 0.05 ) . The discomfort score correlated well with the pain relief scoring without any significant difference between the two groups except in the last visit ( at 3 month ) . Incidences of the complications were comparable in the two groups ( P > 0.05 ) . CONCLUSION Ultrasound-guided celiac plexus neurolysis using unilateral paramedian ( single needle ) needle-insertion technique is comparable with bilateral paramedian ( double needle ) needle-insertion technique with regard to pain relief and side effects .
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Intervention_Surgical
ultrasound-guided celiac plexus neurolysis
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Intervention_Surgical
bilateral paramedian
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Intervention_Surgical
unilateral paramedian needle-insertion technique
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Intervention_Surgical
Percutaneous anterior abdominal ultrasound guidance
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Intervention_Surgical
ultrasound-guided celiac plexus neurolysis ( USCPN )
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Intervention_Surgical
USCPN
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Intervention_Surgical
bilateral paramedian ( double needle ) technique
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Intervention_Surgical
unilateral paramedian ( single needle ) technique
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Intervention_Pharmacological
ethanol
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Intervention_Pharmacological
bupivacaine
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Outcome_Pain
pain relief
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Outcome_Other
patient satisfaction scores
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Outcome_Pain
pain relief
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Outcome_Adverse-effects
side effects
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Participant_Condition
upper abdominal cancer
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Participant_Condition
Sixty
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Participant_Age
18 years or older
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Participant_Condition
upper abdominal cancers