Comparison of CT-Guided Celiac Plexus Neurolysis and Pharmacotherapy

NCT07761650 | Completed DMC

• 1 other identifier: 184/RC/KEMU
• Study Type: interventional
• Target: 110
• Locations: 1 country
• Sites: 1

Brief Summary

After enrolment, patients were randomly assigned to two groups by means of a lottery procedure, whereby each patient blindly chose one of two labelled slips, resulting in group assignment to receive. Group A patients were subjected to CT-guided celiac plexus neurolysis, and Group B patients to standard pharmacotherapy for managing the pain over a period of four weeks. CT-guided celiac plexus neurolysis under the supervision of the principal investigator, using local anaesthetic and absolute ethanol injection for neurolysis, was carried out using aseptic technique. Baseline demographic information, which included age, gender, nature of malignancy, and the duration of disease, was recorded using a predesigned proforma. Pain severity was measured by the Visual Analogue Scale (VAS), a recognised 0-10 scale where 0 = no pain to 10 indicating the worst imaginable pain, at baseline and after 4 weeks of treatment. The major outcome measure was the average pain score at four weeks in both groups.

Conditions

Upper Abdominal Malignancies; Upper Gastrointestinal Cancer

Keywords

Upper Gastrointestinal Malignancies; Celiac Plexus Neurolysis; Pharmacotherapy; Palliative Care; Visual Analogue Scale; Pain Management

Outcome Measures

Primary Outcomes (1)

• Average pain score at baseline and after 4 weeks of treatment

  Pain severity was measured by the Visual Analogue Scale (VAS), a recognized 0-10 scale where zero is equivalent to no pain and 10 indicates the worst imaginable pain, at baseline and after 4 weeks of treatment.

  Baseline to 4 weeks

Study Arms (2)

CT-guided celiac plexus neurolysis

EXPERIMENTAL

Procedure: CT-guided celiac plexus neurolysis

Standard pharmacotherapy

ACTIVE COMPARATOR

Procedure: Standard pharmacotherapy

Interventions

CT-guided celiac plexus neurolysis PROCEDURE

Under intermittent CT guidance, one or two 20-22-gauge Chiba needles are advanced via a posterior paravertebral approach to the anterolateral aspect of the aorta at the level of the celiac axis. Correct needle placement is confirmed by CT imaging and the injection of a small amount of nonionic contrast material to ensure appropriate spread and exclude intravascular or intrathecal positioning. Following negative aspiration for blood or cerebrospinal fluid, a test dose of local anesthetic (commonly 5-10 mL of 1% lidocaine) is administered to minimize procedural pain and assess for adverse effects. Subsequently, a neurolytic agent, typically 15-25 mL of 95-100% absolute alcohol or 6-10% phenol on each side depending on the technique used, is slowly injected under CT guidance to achieve circumferential spread around the celiac plexus. A final CT scan is obtained to document the distribution of the neurolytic solution and exclude immediate complications.

CT-guided celiac plexus neurolysis

Standard pharmacotherapy PROCEDURE

Patients will be provided with the standard oral and intravenous analgesics such as fentanyl and oxycodone.

Standard pharmacotherapy

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Biopsy proven upper GI malignancy with severe abdominal pain
• Patients aged 18 to 65 years of either gender

You may not qualify if:

• Pregnant and lactating females
• Anemia (hemoglobin \<10 g/dL)
• Massive ascites
• Chronic renal failure
• Patients with known allergy or intolerance to drugs used during celiac plexus neurolysis (CT guided technique).

Sponsors & Collaborators

• Mayo Hospital Lahore: lead

Study Sites (1)

Mayo Hospital

Lahore, Punjab Province, 54000, Pakistan

Location

Related Publications (2)

• Daniels M, Duran E, Pan V, Rentzepis P, An T, Thabet A, Hao D. Computed Tomography-Guided Celiac Plexus Block and Neurolysis: Technical Outcomes and Complications. Pain Physician. 2026 Jan;29(1):E59-E66.

  PMID: 41628217 BACKGROUND

• Faghih M, Damm M, Bandhauer C, Jager J, Olesen SS, Laheru DA, Zheng L, Phillips AE, Yadav D, Drewes AM, Rosendahl J, Singh VK. Pancreatic adenocarcinoma patients with pain have abnormal central pain processing. Pancreatology. 2025 May;25(3):426-432. doi: 10.1016/j.pan.2025.04.010. Epub 2025 Apr 16.

  PMID: 40382254 BACKGROUND

MeSH Terms

Conditions

Gastrointestinal Neoplasms; Agnosia

Condition Hierarchy (Ancestors)

Digestive System Neoplasms; Neoplasms by Site; Neoplasms; Digestive System Diseases; Gastrointestinal Diseases; Perceptual Disorders; Neurobehavioral Manifestations; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Dr.

Study Record Dates

• First Submitted: August 2, 2026
• First Posted: August 12, 2026
• Study Start: May 1, 2025
• Primary Completion: August 30, 2025
• Study Completion: November 30, 2025
• Last Updated: August 12, 2026

Record last verified: 2026-08

Data Sharing

• IPD Sharing: Will share

Locations

PA (1)