Comparison of Splanchnic Nerve Block with Ropivacaine/ Depo Medrol and Ropivacaine/Depo Medrol/Fentanyl in Patients Suffering from Abdominal Pain Due to Pancreatic Cancer

Alireza Khajehnasiri; Reza Atef Yekta; Nader Ali Nazemian; Bahar Fereydonnia; Foad Fouladi

doi:10.18502/aacc.v10i4.16268

Alireza Khajehnasiri Pain Research Center, Neuroscience Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Reza Atef Yekta Pain Research Center, Neuroscience Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Nader Ali Nazemian Pain Research Center, Neuroscience Institute, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Bahar Fereydonnia Pain Research Center, Neuroscience Institute, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Foad Fouladi Pain Research Center, Neuroscience Institute, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.

DOI: https://doi.org/10.18502/aacc.v10i4.16268

Keywords: Splanchnic block; Pain; Pancreatic cancer; Pharmaceutical; Painkillers

Abstract

Background: This double-blind clinical trial aimed to investigate the effectiveness of splanchnic nerve blocks using different medication combinations on pain severity and duration of pain relief in patients with pancreatic cancer-related abdominal pain.

Methods: Thirty eligible patients were randomly assigned to either a control group receiving splanchnic blocks with Ropivacaine/Depo Medrol/Saline or an intervention group receiving splanchnic blocks with Ropivacaine/Depo Medrol/Fentanyl. Pain severity was assessed using the Numeric Rating Scale (NRS) at 2, 6, and 24 hours and one week post-intervention. Statistical analysis included independent t-tests, Friedman tests, and False Discovery Rate (FDR) correction.

Results: Prior to intervention, no significant difference in NRS scores was observed between groups (p = 0.0642). However, at the 6-hour and one-week intervals, the case group exhibited significantly lower NRS scores than the control group, indicating the efficacy of the intervention in reducing pain levels. The case group showed a substantial decrease in NRS scores from a pre-intervention mean of 7.8 to 0.5 at 2 hours, while the control group experienced a reduction from 9.083 to 2.583. The mean duration of pain relief was longer in the case group (5.429 days) compared to the control group (3.25 days). Friedman tests revealed significant differences in pain scores across time intervals within both groups (p < 0.001).

Conclusion: Splanchnic nerve blocks using Ropivacaine/Depo Medrol/Fentanyl combination demonstrated significant pain reduction effects, particularly at 6 hours and one-week post-intervention, compared to the control group. These findings showed that the addition of fentanyl in pharmaceutical combination as a opioid to the splanchnic block has reduced the pain score and increase the duration of pain relief in patients being involved in pancreatic cancer with abdominal pain.