The neurolytic blocks of sympathetic chains are commonly used for the treatment of cancer-related pain. This study aims to compare celiac plexus neurolysis and splanchnic nerve neurolysis for the treatment of abdominal visceral pain and its influence on the quality of life of patients with cancer.
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Splanchnic nerve neurolysis - 5 ml of absolute alcohol (100%)
Procedure/SurgerySplanchnic neurolysis will be performed with 5 ml of absolute alcohol on each side at the level of the eleventh thoracic vertebra.
Celiac Plexus Neurolysis - 5 ml of absolute alcohol (100%)
Procedure/SurgeryCeliac plexus neurolysis will be performed with 5 ml of absolute alcohol on each side at the level of the first lumbar vertebra.
PAIN SCORE
Pain will be assessed using the Numerical Rating Scale (NRS), a scale from 0 to 10 where: 0 indicates no pain and 10 indicates the worst possible pain. Scores are typically categorized as: Mild pain: 0-3 Moderate pain: 4-6 Severe pain: 7-10 Additionally, the Descriptive Verbal Scale will be used, with the following categories: No pain Mild pain Moderate pain Severe pain.
Quality of life assessment.
Quality of life will be assessed using the Brief Pain Inventory - Short Form (SF-36) questionnaire, which evaluates both pain intensity and its impact on daily functioning. The questionnaire covers two main areas: Pain Severity - Patients rate their pain at its: Worst Least Average Current (right now) (using a 0-10 numeric scale, where 0 = no pain and 10 = pain as bad as you can imagine). Pain Interference - Assesses how much pain interferes with: General activity Mood Walking ability Normal work Relationships with others Sleep Enjoyment of life (also rated on a 0-10 scale, where 0 = does not interfere and 10 = completely interferes). Additionally, the questionnaire includes: A pain location diagram Information about current pain medications and their effectiveness Description of pain relief methods.
Adverse Events
Adverse events inherent to the studied procedures will be assessed and recorded. These include: Abdominal pain; Diarrhea; Hypotension (low blood pressure); Back pain; Nausea and vomiting; Fever; Bloating or abdominal distention; Delayed gastric emptying; Injury to surrounding structures (e.g., blood vessels or organs); Nerve damage; Impaired digestive function; Local infection at the puncture site; Loss of autonomic function; Pneumothorax.
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