Comparison of Transdiscal and Paravertebral Approaches for Neurolytic Splanchnic Nerve Block in Upper Abdominal Cancer Pain Treatment

What this Trial Is About

This research aims to compare two methods of splanchnic nerve neurolysisthe fluoroscopy-guided paravertebral PV and transdiscal TD approachesin patients experiencing severe upper abdominal cancer-related pain from malignancies like gastric, pancreatic, and hepatic cancers. The study focuses on evaluating which approach better reduces pain and improves quality of life, addressing a complex condition that is often difficult to manage with standard medical therapies alone. The trial involves two groups of patients, each receiving one of the neurolysis techniques. In the transdiscal approach, a needle is guided through the intervertebral disc under fluoroscopy to deliver alcohol for nerve block, while the paravertebral method targets the nerve beside the vertebral body with similar guidance and alcohol injection. Both procedures use local anesthesia and imaging to ensure accurate placement, followed by a test dose to confirm pain relief before the full neurolytic agent is administered. Participants will be closely monitored before and after the procedure using pain scores Numerical Rating Scale at 3 days, 1 month, and 3 months. Quality of life will be assessed with a standardized questionnaire at 1 and 3 months. Researchers will also record procedure times, fluoroscopy imaging duration, opioid use, and any adverse events. The total follow-up includes assessments up to three months after treatment to evaluate the lasting effects of each neurolysis technique.

Transdiscal vs Paravertebral Neurolytic Splanchnic Nerve Block for Upper Abdominal Cancer Pain