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Clinical Outcomes and Safety of Fluoroscopy-Guided Transdiscal Splanchnic Nerve Neurolysis in Patients With Upper Abdominal Cancer Pain: A Prospective Cohort Study
Sponsor study identifier
interventional
40
1 country
1
Study Start
September 20, 2026
Estimated (date passed)This estimate has passed. The registry has not confirmed an actual date for this milestone.
Primary Completion
March 20, 2027
EstimatedPlanned date reported by the registry; this milestone is not confirmed as achieved.
Study Completion
April 20, 2027
EstimatedPlanned date reported by the registry; this milestone is not confirmed as achieved.
The goal of this prospective study is to learn whether fluoroscopy-guided transdiscal splanchnic nerve neurolysis can safely reduce severe upper abdominal cancer pain in adults with pancreatic, gastric, or hepatobiliary cancer. The study will also assess whether this procedure can reduce the need for opioid pain medicines and improve patients' functional status and quality of life. The main questions it aims to answer are: Does the procedure reduce patients' pain one month after treatment? Does it reduce the amount of opioid pain medication patients need? Does it improve functional status and quality of life? What complications or side effects occur after the procedure? How long does pain relief last, and how often is repeat treatment needed? Participants will: First receive a diagnostic splanchnic nerve block with local anesthetic. If the diagnostic block provides at least 50% pain relief, undergo transdiscal splanchnic nerve neurolysis using fluoroscopy guidance. Receive a neurolytic agent (absolute alcohol or phenol) through a needle placed at the T11-T12 or T12-L1 level. Have their pain, opioid medication use, functional status, complications, and satisfaction assessed before treatment and during follow-up. Complete follow-up assessments at 1 week, 1 month, 3 months, and 6 months after the procedure. Complete a quality-of-life questionnaire before treatment and at 1 month. The primary outcome will be the change in pain score on the 0-10 Numeric Rating Scale at 1 month after the procedure.
Registry-reported information. Elapsed time and enrollment totals alone do not measure study progress or recruitment pace.
April 20, 2027
EstimatedPlanned date reported by the registry; this milestone is not confirmed as achieved.
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Some registry-reported names shown below are not yet linked in this graph.
Dates and qualifiers reported by the registry. Estimated dates do not confirm that a milestone has occurred.
September 12, 2026
Actual (reported)September 17, 2026
Actual (reported)September 20, 2026
Estimated (date passed)This estimate has passed. The registry has not confirmed an actual date for this milestone.
March 20, 2027
EstimatedPlanned date reported by the registry; this milestone is not confirmed as achieved.
April 20, 2027
EstimatedPlanned date reported by the registry; this milestone is not confirmed as achieved.
Change in pain intensity
Pain intensity will be assessed using the 0-10 Numeric Rating Scale (NRS), where 0 represents no pain and 10 represents the worst imaginable pain. The change in NRS pain score from baseline will be assessed following fluoroscopy-guided transdiscal splanchnic nerve neurolysis.
Baseline to 1 month after the procedure
Change in quality of life
Baseline, 1 month, 3 months, and 6 months
Technical success of neurolysis
During the procedure
Participant will undergo chemical neurolysis using the study specified neurolytic agent for management of chronic pain. the intervention will be administered according to study protocol, with participant followed prospectively for pain relief and treatment related outcomes
Chemical neurolysis will be performed using the study-specified neurolytic agent (alcohol or phenol) to provide pain relief in patients with chronic pain. The procedure will be performed under appropriate clinical and imaging guidance according to the study protocol. Participants will be followed prospectively to assess pain relief, duration of analgesia, functional outcomes, and procedure-related adverse events
Registry-reported names are shown in full. Names without a link have not yet been matched to a Syfrah profile.
Sahiwal Teaching Hospital
Sahiwal, Punjab Province, 57000, Pakistan
von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP; STROBE Initiative. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. BMJ. 2007 Oct 20;335(7624):806-8. doi: 10.1136/bmj.39335.541782.AD.
Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, de Haes JC, et al. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst. 1993 Mar 3;85(5):365-76. doi: 10.1093/jnci/85.5.365.
First Submitted
September 12, 2026
First Posted
September 17, 2026
Study Start
September 20, 2026
Estimated (date passed)This estimate has passed. The registry has not confirmed an actual date for this milestone.
Primary Completion
March 20, 2027
Opioid consumption
Baseline, 1 week, 1 month,
Contact the study team to confirm eligibility.
Goyal S, Kumar A, Goyal D, Attar P, Bhandari B, Purohit G, Mahiswar AP, Gupta S. Efficacy of splanchnic nerve neurolysis in the management of upper abdominal cancer pain: A systematic review and meta-analysis. Indian J Anaesth. 2023 Dec;67(12):1036-1050. doi: 10.4103/ija.ija_439_23. Epub 2023 Dec 13.
Luo L, Cao X, Qiu M, Zhu M, Yan Y, Zhang D, Zhang X. Splanchnic nerve block via transdiscal and paraspinal approach in the treatment of pain in advanced pancreatic cancer: A randomized controlled trial. Medicine (Baltimore). 2025 Sep 19;104(38):e44250. doi: 10.1097/MD.0000000000044250.
Yanaizumi R, Nagamine Y, Harada S, Kuramochi T, Ota S, Abe Y, Nakagawa M, Kamijima K, Hayashi M, Tazawa T, Ogawa K, Goto T. Efficacy and Safety of Neurolytic Splanchnic Nerve Block via Transintervertebral Disc Approach to Retrocrural Space: A Multicenter Retrospective Study. Pain Ther. 2022 Dec;11(4):1359-1372. doi: 10.1007/s40122-022-00432-7. Epub 2022 Sep 28.
Cai Z, Zhou X, Wang M, Kang J, Zhang M, Zhou H. Splanchnic nerve neurolysis via the transdiscal approach under fluoroscopic guidance: a retrospective study. Korean J Pain. 2022 Apr 1;35(2):202-208. doi: 10.3344/kjp.2022.35.2.202.
Kong YG, Shin JW, Leem JG, Suh JH. Computed Tomography (CT) Simulated Fluoroscopy-Guided Transdiscal Approach in Transcrural Celiac Plexus Block. Korean J Pain. 2013 Oct;26(4):396-400. doi: 10.3344/kjp.2013.26.4.396. Epub 2013 Oct 2.
Plancarte-Sanchez R, Mayer-Rivera F, del Rocio Guillen Nunez M, Guajardo-Rosas J, Acosta-Quiroz CO. [Transdiscal percutaneous approach of splanchnic nerves]. Cir Cir. 2003 May-Jun;71(3):192-203. Spanish.
Dong D, Zhao M, Zhang J, Huang M, Wang Y, Qi L, Wan CF, Yu X, Song T. Neurolytic Splanchnic Nerve Block and Pain Relief, Survival, and Quality of Life in Unresectable Pancreatic Cancer: A Randomized Controlled Trial. Anesthesiology. 2021 Oct 1;135(4):686-698. doi: 10.1097/ALN.0000000000003936.
Shwita AH, Amr YM, Okab MI. Comparative Study of the Effects of the Retrocrural Celiac Plexus Block Versus Splanchnic Nerve Block, C-arm Guided, for Upper Gastrointestinal Tract Tumors on Pain Relief and the Quality of Life at a Six-month Follow Up. Korean J Pain. 2015 Jan;28(1):22-31. doi: 10.3344/kjp.2015.28.1.22. Epub 2015 Jan 2.
Zhong W, Yu Z, Zeng JX, Lin Y, Yu T, Min XH, Yuan YH, Chen QK. Celiac plexus block for treatment of pain associated with pancreatic cancer: a meta-analysis. Pain Pract. 2014 Jan;14(1):43-51. doi: 10.1111/papr.12083. Epub 2013 May 20.
2. International Agency for Research on Cancer. Global Cancer Observatory: Cancer Today-Pakistan. GLOBOCAN 2022. Lyon, France: IARC; 2024
van den Beuken-van Everdingen MH, Hochstenbach LM, Joosten EA, Tjan-Heijnen VC, Janssen DJ. Update on Prevalence of Pain in Patients With Cancer: Systematic Review and Meta-Analysis. J Pain Symptom Manage. 2016 Jun;51(6):1070-1090.e9. doi: 10.1016/j.jpainsymman.2015.12.340. Epub 2016 Apr 23.
Planned date reported by the registry; this milestone is not confirmed as achieved.
Study Completion
April 20, 2027
EstimatedPlanned date reported by the registry; this milestone is not confirmed as achieved.
Last Updated
September 17, 2026
Record last verified: 2026-09
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