Clinical trial · Interventional
Neurolytic Block Techniques In Abdominal Visceral Cancer Pain
Comparison of Neurolytic Block Techniques for the Treatment of Abdominal Visceral Pain and Their Influence On The Quality of Life of Patients With Cancer
NCT06978673CI-TRIAL-00090473CONCERNnot yet recruitingN/AClinicalTrials.gov clinicaltrialsProvenance
- Source
- ClinicalTrials.gov
- Retrieved
- Sep 8, 2026
- Layer
- normalized (units and labels harmonized; values unchanged)
- Run
- ING-CLINICALTRIALS-20260908-000001
Summary
Brief summary (as posted)
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.
Conditions
Conditions (8)
Free-text conditions as registered, with the CancerIndex entity they were reconciled to and the match type.
| Condition (as posted) | Mapped entity | Match | Confidence |
|---|---|---|---|
| Abdominal Cancer | Malignant Abdominal Neoplasm | ALIAS | 0.90 |
| Cancer, Malignant Tumors | Malignant Neoplasm | ALIAS | 0.85 |
| Cancer Pain | — | UNRESOLVED | — |
| Cancer-related Pain | — | UNRESOLVED | — |
| Celiac Ganglia | — | UNRESOLVED | — |
| Pain Management | — | UNRESOLVED | — |
| Sympathetic Ganglia | — | UNRESOLVED | — |
| Visceral Pain | — | UNRESOLVED | — |
Interventions
Interventions (2)
| Intervention | Type | Mapped drug | Match |
|---|---|---|---|
| Celiac Plexus Neurolysis - 5 ml of absolute alcohol (100%) | Procedure | — | UNRESOLVED |
| Splanchnic nerve neurolysis - 5 ml of absolute alcohol (100%) | Procedure | — | UNRESOLVED |
Design
Arms and outcomes
Arms (2)
- type
- ACTIVE_COMPARATOR
- label
- CELIAC PLEXUS NEUROLYSIS
- description
- The patient, under sedation and breathing spontaneously with oxygen support, will be placed in the horizontal prone position. Fluoroscopy will be used to locate the first lumbar vertebra, which will serve as a reference for the puncture site. Two 22G × 15 cm needles will be introduced bilaterally, up to 6 cm from the midline at the level of L1, and directed superiorly toward the transverse process of L1 under coaxial vision. Once they reach the vertebral body bilaterally, the needles will be positioned anterior to the vertebral body of L1, in the retroperitoneal region. The needle stylet will be removed, and the absence of blood, cerebrospinal fluid, or urine returning through the needle will be verified. If none of these signs are present, 2 ml of non-ionic contrast will be administered through the needle to confirm proper positioning in the retroperitoneum. After confirmation, 5 ml of absolute alcohol will be injected bilaterally.
- interventionNames
- Procedure: Celiac Plexus Neurolysis - 5 ml of absolute alcohol (100%)
- type
- EXPERIMENTAL
- label
- SPLANCHNIC NERVE NEUROLYSIS
- description
- The patient, under spontaneous breathing with oxygen support, will be placed in the horizontal prone position and supported by cushions placed under the iliac crests and chest. With a mark maintained over T11, the fluoroscopy machine will be positioned obliquely (approximately 45º), and the movement of the diaphragm-as well as its relationship with the vertebral body-will be observed during inspiration and expiration. The entry point will be at the junction of the rib and the vertebral body. The needle will be introduced using coaxial visualization to reach the lateral aspect of the vertebral body, near the costovertebral angle. With the fluoroscopy in profile, the needle will be advanced to the anterior third of the vertebral body, and any return of blood or cerebrospinal fluid will be checked. Non-ionic contrast will then be injected to confirm the needle position in both anteroposterior and lateral views. Finally, 5 ml of absolute alcohol will be injected through each needle.
Eligibility
Eligibility (as posted)
- Sex
- All
- Minimum age
- 18 Years
Show eligibility criteria text
Inclusion Criteria: Patients aged 18 years or older Presence of localized visceral pain in the upper abdomen originating from cancer of the stomach, duodenum, distal esophagus, ascending or transverse colon, liver, biliary tract, or pancreas Ineffectiveness of analgesic treatment with third-step opioids according to the WHO analgesic ladder, including: Opioids (≥ 60 mg/day of morphine equivalents) Antidepressants (tricyclic or dual-action), at any dosage Gabapentinoids, at any dosage Presence of side effects from analgesics that are difficult to manage with medication Exclusion Criteria: Presence of ascites Presence of deep vein thrombosis Presence of hepatic failure: Child-Pugh class B or C Presence of renal failure: estimated glomerular filtration rate (eGFR) \< 60 ml/min/1.73 m² Use of any anticoagulant medication Clinical coagulation disorder, defined as: INR \> 1.5 Prothrombin activity \< 70% or prothrombin time \> 13.5 seconds aPTT \> 40 seconds Cardiovascular failure: NYHA class III
References
Publications (9)
- BACKGROUNDKoyyalagunta D, Engle MP, Yu J, Feng L, Novy DM. The Effectiveness of Alcohol Versus Phenol Based Splanchnic Nerve Neurolysis for the Treatment of Intra-Abdominal Cancer Pain. Pain Physician. 2016 May;19(4):281-92. PMID 27228515
- BACKGROUNDAhmed A, Arora D. Fluoroscopy-guided Neurolytic Splanchnic Nerve Block for Intractable Pain from Upper Abdominal Malignancies in Patients with Distorted Celiac Axis Anatomy: An Effective Alternative to Celiac Plexus Neurolysis - A Retrospective Study. Indian J Palliat Care. 2017 Jul-Sep;23(3):274-281. doi: 10.4103/IJPC.IJPC_28_17. PMID 28827930
- BACKGROUNDUehara Y, Matsumoto Y, Kosugi T, Sone M, Nakamura N, Mizushima A, Miyashita M, Morita T, Yamaguchi T, Satomi E. Availability of and factors related to interventional procedures for refractory pain in patients with cancer: a nationwide survey. BMC Palliat Care. 2022 Sep 26;21(1):166. doi: 10.1186/s12904-022-01056-6. PMID 36154936
- BACKGROUNDHochberg U, Ingelmo P, Sole E, Miro J, Rivera G, Perez J. Early Interventional Treatments for Patients with Cancer Pain: A Narrative Review. J Pain Res. 2023 May 18;16:1663-1671. doi: 10.2147/JPR.S405808. eCollection 2023. PMID 37223437
- BACKGROUNDNoble M, Gress FG. Techniques and results of neurolysis for chronic pancreatitis and pancreatic cancer pain. Curr Gastroenterol Rep. 2006 Apr;8(2):99-103. doi: 10.1007/s11894-006-0004-x. PMID 16533471
- BACKGROUNDComlek S. Pain Control with Splanchnic Neurolysis in Pancreatic Cancer Patients Unresponsive to Celiac Plexus Neurolysis. J Pain Res. 2020 Aug 12;13:2023-2031. doi: 10.2147/JPR.S266689. eCollection 2020. PMID 32848449
- BACKGROUNDYamamuro M, Kusaka K, Kato M, Takahashi M. Celiac plexus block in cancer pain management. Tohoku J Exp Med. 2000 Sep;192(1):1-18. doi: 10.1620/tjem.192.1.