Predictors of pain response after endoscopic ultrasound-guided celiac plexus neurolysis for abdominal pain caused by pancreatic malignancy

Table 1 Baseline characteristics of patients who underwent endoscopic ultrasound-guided celiac plexus neurolysis [n (%), n = 58]

Independent variables	Total number
Age in yr, range (mean)	54–73 (67)
Gender, female/male	25/33
Symptom
Abdominal pain concomitant with jaundice Tumor largest dimension in mm, range (mean)	6 (10.3)
Ascites, slight or mild	24–100 (44.3)
Tumor location	4 (6.9)
Pancreatic head/neck
Pancreatic body/tail	18 (31.0)
Initial VAS score, range (mean)	40 (69.0)
Tramadol use before EUS-CPN	6-10 (8)
Dose in mg, range (mean)	51 (87.9)
Ganglia visualized	0-240 (40)
Invasion of celiac plexus	42 (72.4)
Distant metastasis	16 (27.6)
Injected alcohol dose in mL, range (mean)	26 (44.8)
Procedure method	5–20 (10)
Unilateral
Bilateral	33 (56.9)
Intra-procedural decrease in heart rate	25 (43.1)
decrease of ≥ 5 beats for ≥ 10 s
	48 (82.8)

EUS-CPN: Endoscopic ultrasound-guided celiac plexus neurolysis; VAS: Visual analog scale.

Table 2 Univariable analysis of variables associated with pain response after 1 wk in the enrolled cohort of 58 patients

Independent variables	OR	95%CI	P value
Age in yr	1.084	0.60-3.88	0.212
Gender, female/male	1.39	0.43-3.79	0.64
Symptom
Abdominal pain concomitant with jaundice	1.29	0.53–3.26	0.581
Tumor largest dimension	1.32	0.45-4.69	0.665
Ascites	1.772	0.59–6.84	0.437
Tumor location
Pancreatic head/neck	2.071	0.60-7.09	0.232
Pancreatic body/tail	0.617	0.65-10.40	0.094
Initial VAS score	2.231	0.76-5.41	0.132
Tramadol use before EUS-CPN	1.339	0.54-15.39	0.327
Invisible ganglia	3.574	1.80-14.24	0.003
Invasion of celiac plexus	7.922	2.24-25.93	0.001
Distant metastasis	5.94	1.31–11.82	0.015
Injected alcohol dose	3.825	1.12–13.42	0.437
Procedure method
Unilateral	1.677	0.84–11.48	0.591
Bilateral	0.489	0.11–1.12	0.087
Intra-procedural decrease in heart rate	1.011	0.91–2.08	0.933

OR: Odds ratio; CI: Confidence interval; EUS-CPN: Endoscopic ultrasound-guided celiac plexus neurolysis; VAS: Visual analogue scale.

Table 3 Multivariate analysis for predictors affecting pain response after 1 wk by endoscopic ultrasound-guided celiac plexus neurolysis

Independent variables	OR	95%CI	P value
Ganglia invisible	4.9	2.25-17.91	0.011
Invasion of celiac plexus	13.2	3.02-46.27	0.003
Distant metastasis	6.84	2.34–19.15	0.022

Summarizes the results of the multivariate analyses of the predictive factors associated with pain relief by EUS-CPN. The only independent predictive factors that achieved statistical significance in the univariate analysis were included. CI: Confidence interval; EUS-CPN: Endoscopic ultrasound-guided celiac plexus neurolysis; OR: Odds ratio.

Table 4 Univariable analysis of variables associated with pain response after 4 wk in the enrolled cohort of 58 patients

Independent variables	OR	95%CI	P value
Age in yr	1.091	0.63-3.94	0.209
Gender, female/male	1.124	0.47-3.99	0.532
Symptom
Abdominal pain concomitant with	1.384	0.43–4.82	0.618
jaundice	1.496	0.32-5.92	0.701
Tumor largest dimension	1.921	0.79–9.34	0.408
Ascites
Tumor location	3.59	0.40-10.06	0.184
Pancreatic head/neck	0.42	0.15-12.77	0.082
Pancreatic body/tail	2.93	0.42-8.17	0.101
Initial VAS score	2.91	0.24-19.40	0.149
Tramadol use before EUS-CPN	4.02	1.62-13.27	0.003
Invisible ganglia	8.84	2.11-23.32	0.001
Invasion of celiac plexus	7.83	1.81–15.77	0.009
Distant metastasis	4.90	1.32–17.91	0.394
Injected alcohol dose
Procedure method	2.87	0.44–17.41	0.502
Unilateral	0.54	0.16–1.99	0.093
Bilateral	0.94	0.42–3.12	0.858
Intra-procedural decrease in heart rate

CI: Confidence interval; EUS-CPN: Endoscopic ultrasound-guided celiac plexus neurolysis; OR: Odds ratio; VAS: Visual analogue scale.

Table 5 Multivariate analysis for predictors affecting pain response after 4 wk by endoscopic ultrasound-guided celiac plexus neurolysis

Independent variables	OR	95%CI	P value
Invisible ganglia	5.85	2.66-22.73	0.037
Invasion of celiac plexus	15.11	4.01-51.22	0.001
Distant metastasis	8.59	2.16–27.02	0.019

Summarizes the results of the multivariate analyses of the predictive factors associated with pain relief by EUS-CPN. The only independent predictive factors that achieved statistical significance in the univariate analysis were included. CI: Confidence interval; EUS-CPN: Endoscopic ultrasound-guided celiac plexus neurolysis; OR: Odds ratio.