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RECRUITING Not applicable ClinicalTrials.gov

Coeliac Plexus vs Splanchnic Nerve Neurolysis for Upper Abdominal Cancer Pain

Sponsor: Bangladesh Medical University • ClinicalTrials.gov ID: NCT07653906

Registry updated: 2026-09-04
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Description

The goal of this clinical trial is to determine whether Neurolytic Splanchnic Nerve Block (NSNB) reduces pain in adults with upper abdominal malignancies. It will also evaluate the safety of Neurolytic Splanchnic Nerve Block (NSNB). The main questions it aims to answer are: Does NSNB reduce pain intensity compared to Neurolytic Coeliac Plexus Block (NCPB), as measured by the Visual Analog Scale (VAS)? What adverse effects do participants experience when receiving Neurolytic Splanchnic Nerve Block (NSNB)? Investigators will compare Neurolytic Splanchnic Nerve Block (NSNB) with Neurolytic Coeliac Plexus Block (NCPB) to determine which intervention provides more effective and safer pain relief. Participants will: * receive either NSNB or NCPB under fluoroscopic guidance * be monitored immediately and for 2 hours after the procedure for any complications Have their pain intensity recorded immediately after the procedure, and at 7 days, 1 month, and 3 months * be evaluated for quality-of-life using European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire - Core 3 (EORTC QLQ-C30) at 1 month and 3 months. * have their opioid consumption tracked throughout the study.

Interventions

  • Neurolytic Coeliac Plexus Block (NCPB) (Procedure)
    Fluoroscopy-guided neurolytic coeliac plexus block performed on adult patients with upper abdominal malignancies. Patients are positioned prone with a pillow under the abdomen. Using posteroanterior and oblique C-arm fluoroscopy, the T12-L1 vertebral bodies are identified. After local anesthetic infiltration, 3 mL of 0.25% bupivacaine is injected, followed by 20 mL of 70% alcohol for neurolysis. A 1 mL saline flush is given during needle withdrawal to prevent track formation. Patients are monitored immediately and for 2 hours post-procedure for adverse effects including hypotension, diarrhea, back pain, shoulder pain, or neurological changes.
  • Neurolytic Splanchnic Nerve Block (NSNB) (Procedure)
    Fluoroscopy-guided neurolytic splanchnic nerve block performed in adults with upper abdominal malignancies. Patients are positioned prone with proper support. Using posteroanterior and lateral C-arm fluoroscopy, T11-T12 vertebral bodies and the junction of the rib and vertebral body are identified. After local anesthetic infiltration, a Chiba needle is advanced to the anterior one-third of the lateral vertebral body. Contrast dye is injected to confirm placement. Neurolysis is performed using 10 mL of 70% alcohol, preceded by 2-3 mL of 0.25% bupivacaine. A 1 mL saline flush is given during needle withdrawal to prevent track formation. Patients are monitored immediately and for 2 hours post-procedure for complications including hypotension, diarrhea, back pain, shoulder pain, pneumothorax, or neurological changes.

Eligibility criteria

Inclusion Criteria: * Adult patient * Both genders * Diagnosed case of upper abdominal malignancy (pancreatic, gastric, hepatic, or biliary origin) * Experiencing moderate to severe pain (≥5 on a 10 point visual analog scale) * Patients who are conscious and can communicate * No Contraindication for nerve block (e.g., coagulopathy, anticoagulant drugs) Exclusion Criteria: * Previous coeliac plexus block, splanchnic nerve block, or major abdominal nerve ablation * Severe spinal deformities or anatomical distortion at the coeliac plexus or splanchnic nerve site * Local or systemic infection at or near the block site * Known allergy to local anesthetics or neurolytic agents * Pregnancy * Lactating mother * Cognitive impairment or psychiatric illness

Conditions

Upper Abdominal Malignancies

Locations

  • Bangladesh Medical University — Dhaka, Bangladesh
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Official Source

Data sourced from ClinicalTrials.gov, a service of the U.S. National Institutes of Health.

View Official Record