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Neurolytic Sympathectomy in the Management of Cancer Pain—Time Effect: A Prospective, Randomized Multicenter Study  Yasser M. Amr, MD, Mohamed Y. Makharita,

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Presentation on theme: "Neurolytic Sympathectomy in the Management of Cancer Pain—Time Effect: A Prospective, Randomized Multicenter Study  Yasser M. Amr, MD, Mohamed Y. Makharita,"— Presentation transcript:

1 Neurolytic Sympathectomy in the Management of Cancer Pain—Time Effect: A Prospective, Randomized Multicenter Study  Yasser M. Amr, MD, Mohamed Y. Makharita, MD  Journal of Pain and Symptom Management  Volume 48, Issue 5, Pages e2 (November 2014) DOI: /j.jpainsymman Copyright © 2014 American Academy of Hospice and Palliative Medicine Terms and Conditions

2 Fig. 1 Flow diagram of patient progress through the phases of the randomized trial. Journal of Pain and Symptom Management  , e2DOI: ( /j.jpainsymman ) Copyright © 2014 American Academy of Hospice and Palliative Medicine Terms and Conditions

3 Fig. 9 Pain scores during follow-up period for both groups expressed as mean ± SD. “*” Significant difference in Group II vs. Group I. Missing data in calculation of mean because of patient deaths are compensated for by using the last reported data value. Therefore, 54 and 55 patients were used at all times of assessment in each group, respectively. Journal of Pain and Symptom Management  , e2DOI: ( /j.jpainsymman ) Copyright © 2014 American Academy of Hospice and Palliative Medicine Terms and Conditions

4 Fig. 10 QLQ-C30 subscales of global quality of life; data were expressed as mean in each group. “*” Significant difference in Group II vs. Group I. Missing data in calculation of mean because of patient death are compensated for by using the last reported data value. Therefore, 54 and 55 patients were used at all times of assessment in each group, respectively. Journal of Pain and Symptom Management  , e2DOI: ( /j.jpainsymman ) Copyright © 2014 American Academy of Hospice and Palliative Medicine Terms and Conditions

5 Fig. 11 QLQ-C30 subscales of symptoms; data were expressed as mean in each group. Journal of Pain and Symptom Management  , e2DOI: ( /j.jpainsymman ) Copyright © 2014 American Academy of Hospice and Palliative Medicine Terms and Conditions

6 Fig. 12 QLQ-C30 subscales of physical functioning; data were expressed as mean in each group. Journal of Pain and Symptom Management  , e2DOI: ( /j.jpainsymman ) Copyright © 2014 American Academy of Hospice and Palliative Medicine Terms and Conditions

7 Fig. 13 QLQ-C30 subscales of role functioning; data were expressed as mean in each group. Journal of Pain and Symptom Management  , e2DOI: ( /j.jpainsymman ) Copyright © 2014 American Academy of Hospice and Palliative Medicine Terms and Conditions

8 Fig. 14 QLQ-C30 subscales of emotional functioning; data were expressed as mean in each group. Journal of Pain and Symptom Management  , e2DOI: ( /j.jpainsymman ) Copyright © 2014 American Academy of Hospice and Palliative Medicine Terms and Conditions

9 Fig. 15 QLQ-C30 subscales of cognitive functioning; data were expressed as mean in each group. Journal of Pain and Symptom Management  , e2DOI: ( /j.jpainsymman ) Copyright © 2014 American Academy of Hospice and Palliative Medicine Terms and Conditions

10 Fig. 16 QLQ-C30 subscales of social functioning; data were expressed as mean in each group. Journal of Pain and Symptom Management  , e2DOI: ( /j.jpainsymman ) Copyright © 2014 American Academy of Hospice and Palliative Medicine Terms and Conditions

11 Fig. 17 Survival after randomization (Kaplan-Meier curve).
Journal of Pain and Symptom Management  , e2DOI: ( /j.jpainsymman ) Copyright © 2014 American Academy of Hospice and Palliative Medicine Terms and Conditions

12 Fig. 2 Anteroposterior view with dye in midline (transaortic celiac block). Journal of Pain and Symptom Management  , e2DOI: ( /j.jpainsymman ) Copyright © 2014 American Academy of Hospice and Palliative Medicine Terms and Conditions

13 Fig. 3 Lateral view should confirm pre-aortic T12-L1 spread (transaortic celiac block). Journal of Pain and Symptom Management  , e2DOI: ( /j.jpainsymman ) Copyright © 2014 American Academy of Hospice and Palliative Medicine Terms and Conditions

14 Fig. 4 Anteroposterior view with both needles at the level of L1 disc space and dye distributed up and down hugging the lateral wall of the vertebral body (celiac plexus block with bilateral needle technique). Journal of Pain and Symptom Management  , e2DOI: ( /j.jpainsymman ) Copyright © 2014 American Academy of Hospice and Palliative Medicine Terms and Conditions

15 Fig. 5 Lateral view with both needles and dye distributed up and down (celiac plexus block with bilateral needle technique). Journal of Pain and Symptom Management  , e2DOI: ( /j.jpainsymman ) Copyright © 2014 American Academy of Hospice and Palliative Medicine Terms and Conditions

16 Fig. 6 Anteroposterior view with needle at the level of T11 vertebral body and dye distributed up and down hugging the lateral wall of the vertebral body (splanchnic nerve block). Journal of Pain and Symptom Management  , e2DOI: ( /j.jpainsymman ) Copyright © 2014 American Academy of Hospice and Palliative Medicine Terms and Conditions

17 Fig. 7 Lateral view with needle at the level of T11 and needle tip at the junction of anterior one-third and posterior two-thirds of vertebral body and dye distributed up and down (splanchnic nerve block). Journal of Pain and Symptom Management  , e2DOI: ( /j.jpainsymman ) Copyright © 2014 American Academy of Hospice and Palliative Medicine Terms and Conditions

18 Fig. 8 Lateral view with the needle was introduced through L5-S1 disc with dye distributed in the disc space and dye distributed up and down anterior to the disc (superior hypogastric block, transdiscal approach). Journal of Pain and Symptom Management  , e2DOI: ( /j.jpainsymman ) Copyright © 2014 American Academy of Hospice and Palliative Medicine Terms and Conditions


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