Protocol for a randomized controlled trial of endoscopic ultrasound guided celiac plexus neurolysis (EUS-CPN) with vs without bupivacaine

Abstract Background Pancreatic cancer is a devastating disease with less than 5% 5-year survival. Inoperable patients often present with pain. Randomized controlled trial have shown that endoscopic ultrasound-guided celiac plexus neurolysis (EUS-CPN) improves pain control. It is usually performed by...

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Main Authors: Eslam Esmail, Sarto C Paquin, Anand V Sahai
Format: Article
Language:English
Published: BMC 2023-09-01
Series:Trials
Online Access:https://doi.org/10.1186/s13063-023-07487-7
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author Eslam Esmail
Sarto C Paquin
Anand V Sahai
author_facet Eslam Esmail
Sarto C Paquin
Anand V Sahai
author_sort Eslam Esmail
collection DOAJ
description Abstract Background Pancreatic cancer is a devastating disease with less than 5% 5-year survival. Inoperable patients often present with pain. Randomized controlled trial have shown that endoscopic ultrasound-guided celiac plexus neurolysis (EUS-CPN) improves pain control. It is usually performed by injecting bupivacaine followed by absolute alcohol around the celiac axis. Study design Single center, randomized, double blind controlled trial of EUS-CPN with and without bupivacaine in patients with inoperable malignancy (pancreatic or other) involving the celiac plexus. The study was approved by research ethics board with approval number of 2022-9969, 21.151 and registered on ClinicalTrials.gov (NCT04951804). Discussion We hypothesize that bupivacaine is superfluous and may actually reduce pain control by diluting the neurolytic effect of alcohol. Bupivacaine is also potentially dangerous in that it may produce serious adverse events such as arrythmias and cardiac arrest if inadvertently injected intravascularly. Conclusion This randomized trial is designed to assess whether bupivacaine is of any value during EUS-CPN.
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spelling doaj.art-95024afd6db5454382b3132cace591512023-11-26T14:09:48ZengBMCTrials1745-62152023-09-012411510.1186/s13063-023-07487-7Protocol for a randomized controlled trial of endoscopic ultrasound guided celiac plexus neurolysis (EUS-CPN) with vs without bupivacaineEslam Esmail0Sarto C Paquin1Anand V Sahai2CHUMCHUMCHUMAbstract Background Pancreatic cancer is a devastating disease with less than 5% 5-year survival. Inoperable patients often present with pain. Randomized controlled trial have shown that endoscopic ultrasound-guided celiac plexus neurolysis (EUS-CPN) improves pain control. It is usually performed by injecting bupivacaine followed by absolute alcohol around the celiac axis. Study design Single center, randomized, double blind controlled trial of EUS-CPN with and without bupivacaine in patients with inoperable malignancy (pancreatic or other) involving the celiac plexus. The study was approved by research ethics board with approval number of 2022-9969, 21.151 and registered on ClinicalTrials.gov (NCT04951804). Discussion We hypothesize that bupivacaine is superfluous and may actually reduce pain control by diluting the neurolytic effect of alcohol. Bupivacaine is also potentially dangerous in that it may produce serious adverse events such as arrythmias and cardiac arrest if inadvertently injected intravascularly. Conclusion This randomized trial is designed to assess whether bupivacaine is of any value during EUS-CPN.https://doi.org/10.1186/s13063-023-07487-7
spellingShingle Eslam Esmail
Sarto C Paquin
Anand V Sahai
Protocol for a randomized controlled trial of endoscopic ultrasound guided celiac plexus neurolysis (EUS-CPN) with vs without bupivacaine
Trials
title Protocol for a randomized controlled trial of endoscopic ultrasound guided celiac plexus neurolysis (EUS-CPN) with vs without bupivacaine
title_full Protocol for a randomized controlled trial of endoscopic ultrasound guided celiac plexus neurolysis (EUS-CPN) with vs without bupivacaine
title_fullStr Protocol for a randomized controlled trial of endoscopic ultrasound guided celiac plexus neurolysis (EUS-CPN) with vs without bupivacaine
title_full_unstemmed Protocol for a randomized controlled trial of endoscopic ultrasound guided celiac plexus neurolysis (EUS-CPN) with vs without bupivacaine
title_short Protocol for a randomized controlled trial of endoscopic ultrasound guided celiac plexus neurolysis (EUS-CPN) with vs without bupivacaine
title_sort protocol for a randomized controlled trial of endoscopic ultrasound guided celiac plexus neurolysis eus cpn with vs without bupivacaine
url https://doi.org/10.1186/s13063-023-07487-7
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