Subcostal TAP Block May Relieve Chronic Pancreatitis Pain Subcostal TAP Block May Relieve Chronic Pancreatitis Pain
Subcostal transversus abdominis plane (TAP) block with depot steroids provides durable pain relief in many patients with abdominal pain secondary to chronic pancreatitis, according to an observational study.Reuters Health Information
Pain is often associated with chronic pancreatitis and pancreatic cancer. Often times opioids are used to treat pain; however, the use of opioids is frequently difficult. Endoscopic ultrasound-guided celiac plexus block and celiac plexus nuerolysis are safe and effective modalities used to alleviate pain. Celiac plexus block is a transient interruption of the plexus by local anesthetic, while celiac plexus neurolysis is prolonged interruption of the transmission of pain from the celiac plexus using chemical ablation. Celiac plexus block is generally performed in the unilateral position, while celiac plexus neurolysis is pe...
Celiac plexus blocks (CPB) are administered via percutaneous or endoscopic ultrasonography (EUS) as therapeutic methods to mitigate intense pain in chronic pancreatitis. There are many techniques, dosages, and medications utilized by gastroenterologists, interventional radiologists, and anesthesiologists, but it is currently unclear as to which methods are most effective in eliminating visceral pain. This systematic review aims to consolidate the current medical literature regarding administration of CPB to patients with chronic pancreatitis.
Discussion Several previous studies investigating the two different strategies for postoperative pain management have mainly focused on their effectiveness in pain control. However, the PAKMAN trial is the first to compare them with regard to their impact on the surgical endpoint “postoperative gastrointestinal complications” after pancreatoduodenectomy. Trial registration German Clinical Trials Register, DRKS00007784
CONCLUSIONS We report the first series of single-port video-assisted thoracoscopic surgical (VATS) splanchnotomy for palliation of intractable pain due to chronic pancreatitis. From this small study, single-port VATS splanchnotomy seems to be a safe and effective alternative to multiportal or open procedures.
A 36-year-old patient has a history of seizures and chronic pancreatitis secondary to a car accident that led to pancreatic trauma. He has been on oxycodone and OxyContin for 6months with suboptimal pain control. He had a history of frequent requests for more pain medication and early refills. The patient was admitted to our hospital for a pancreatitis flare. He was due for a urine drug screen (UDS) by his primary care provider, but because the patient was admitted to the hospital at the same time, the test was performed during his hospital stay.
CONCLUSIONS: Low quality evidence suggested that DPPHR may result in shorter hospital stay than PD. Based on low or very low quality evidence, there is currently no evidence of any difference in the mortality, adverse events, or quality of life between DPPHR and PD. However, the results were imprecise and further RCTs are required on this topic. Future RCTs comparing DPPHR with PD should report the severity as well as the incidence of postoperative complications and their impact on patient recovery. In such trials, participant and observer blinding should be performed and the analysis should be performed on an intention-to...
CONCLUSIONS: Bilateral paravertebral catheters may provide decreased opioid use and improved postoperative pain control after TPIAT. PMID: 26749428 [PubMed - as supplied by publisher]
ConclusionsBilateral paravertebral catheters may provide decreased opioid use and improved postoperative pain control after TPIAT.
Conclusion: The therapeutic use of endoscopic ultrasound in the pediatric population is safe and has a high success rate.
Abstract AIM: To share our experience regarding the laparoscopic Frey procedure for chronic pancreatitis (CP) and patient selection. METHODS: All consecutive patients undergoing duodenum-preserving pancreatic head resection from July 2013 to July 2014 were reviewed and those undergoing the Frey procedure for CP were included in this study. Data on age, gender, body mass index (BMI), American Society of Anesthesiologists score, imaging findings, inflammatory index (white blood cells, interleukin (IL)-6, and C-reaction protein), visual analogue score score during hospitalization and outpatient visit, history of...