The effects of the spinal neurolysis in patients with severe cancer pain
- VernacularTitle:Нугасны арын язгуурт хориг хийн хорт хавдрын өвдөлтийг намдаах аргын үр дүн
- Author:
Byambasuren Yondonjamts
;
Odontuya Davaasuren
;
Ganbold Lundeg
- Publication Type:journal article
- Keywords:
cancer pain, spinal, neurolysis, pain score, physical performance
- From:Innovation
2013;7(1):26-31
- CountryMongolia
- Language:English
-
Abstract:
Cancer remains the second leading cause of population mortality in the last 10 years in Mongolia. In 2009, the overwhelming majority (78.3%) of new cancer cases were diagnosed in late stages (III and IY) and 67.06% of cancer patients survived for less than a year after the diagnosis. Pain is the first symptom of cancer in 20-50% of all cancer patients, and 75-90% of advanced or terminal cancer must cope with chronic pain syndromes related to chemotherapy, failed treatment, tumor progression, and associated pathology in tumor bearing tissue. Pain limits daily activity in 41% of patients reporting mild to moderate pain and in 94% of patients reporting moderate to severe pain, leading to greatly diminished quality of life. Drug therapy controls cancer pain in 70-90% of patients with pain follows the World Health Organization’s ladder approach for pain relief. Multiple factors may contribute to dose escalation in cancer patients, including changes in endogenous opioid function, disease progression, and development of opioid-induced hyperalgesia and particularly at high doses, can be associated with severe, sometimes debilitating side effects, including somnolence, mental confusion, and especially constipation. Effective control of cancer pain can now be achieved in a high proportion of patients with rigorously applied pharmacologic treatment, reducing the need for more demanding invasive procedures. Intrathecal neurolysis is a time-tested procedure that has important indications for drug resistant severe pain. Therefore, we aimed to study the effectiveness of spinal neurolytic block in patients with cancer pain.
We studied patients who suffered from pain with advanced cancer of coli uteri in ‘Hope’ hospice and Achtan Clinical hospital of Ulaanbaatar Mongolia from 2011-2012. The study participants were dvided into two groups and observed 10 weeks. In group I morphine therapy oral and injectable and the patients of group II spinal neurolytic block performed with alcohol in patient using oral morphine received. The pain was assessed by Wong Baker Score before and after celiac plexus block and also the functional score was assessed by Karnofsky performance scale.
The result of the study confirm that spinal neurolysis is significantly reduced intensity of the pain, morphine consumption, incidence of drug-induced undesirable side effects and physical performance. The procedure has proved to be very useful in alleviating segmental pain. Pain relief was obtained in 78 percent of the patients, with complications in 2 percent. The technique is the standard subarachnoid puncture and injection of absolute alcohol in small increments up to 1 cc. per interspace.
