Comparison of CT-Guided Celiac Plexus Neurolysis and Pharmacotherapy

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.

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Key information

Conditions

Upper Abdominal Malignancies Agnosia Digestive System Diseases Digestive System Neoplasms Gastrointestinal Diseases Gastrointestinal Neoplasms Neoplasms Neoplasms by Site Nervous System Diseases Neurobehavioral Manifestations Neurologic Manifestations Pathological Conditions, Signs and Symptoms Perceptual Disorders Signs and Symptoms Upper Gastrointestinal Cancer

Age range

18 year–65 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Mayo Hospital

Lahore, Punjab Province, 54000, Pakistan

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

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

Exclusion criteria

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).

Treatment and study plan

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.

Standard pharmacotherapy

Procedure

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

Primary outcomes

Average pain score at baseline and after 4 weeks of treatment

Time frame: Baseline to 4 weeks

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.

Sponsors and collaborators

Lead sponsor

Mayo Hospital Lahore

Other

Registry information

Official study title

Comparison of Analgesic Effects of CT-Guided Celiac Plexus Neurolysis With Pharmacotherapy as Palliative Care of Upper Gastrointestinal Malignancies

Important dates

Study start: 2025
Primary completion: 2025
Study completion: 2025
First posted: Aug 12, 2026
Registry last updated: Aug 12, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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