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Percutaneous splanchnic nerve neurolysis analgesic efficacy and safety for cancer-related pain: a systematic review and meta-analysis

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Abstract

Purpose

To perform a systematic review and meta-analysis of publications to evaluate the analgesic efficacy and safety of percutaneous splanchnic nerve neurolysis (SNN) for cancer-related pain.

Methods

We searched PubMed, Cochrane Library, and Ichushi-Web for English or Japanese articles published up to July 2022 and reporting patients who underwent percutaneous SNN for cancer-related pain. The outcome measures assessed in the systematic review and meta-analysis were the pain measurement scales and morphine equivalents daily dose (MEDD) before and after the intervention and the rate of complications.

Results

Pooled pain measurement scores at pre-intervention, 1–2 weeks, and at 1, 2, 3, and 6 months post-intervention were 6.65 (95% confidence interval [CI], 5.77–7.67, I2 = 97%), 2.79 (95% CI, 2.00–3.88, I2 = 88%), 2.82 (95% CI, 2.49–3.20, I2 = 55%), 2.86 (95% CI, 2.64–3.10, I2 = 0%), 2.99 (95% CI, 2.56–3.46, I2 = 82%), and 3.09 (95% CI, 1.44–6.65, I2 = 70%), respectively. Mean MEDD was described in 8 of the 11 included articles. In all 8 articles, MEDD decreased up to 3 months post-intervention. The pooled minor complication rates for diarrhea and hypotension were 28% (95% CI, 13–49%, I2 = 85%) and 31% (95% CI, 16–51%, I2 = 80%), respectively. The pooled major complication rate was 2% (95% CI, 1–2%, I2 = 0%).

Conclusions

Analysis indicates that percutaneous SNN for cancer-related pain can be performed safely with sustained reduction of pain measurement scales while reducing the administration of opioids.

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Data Availability

All generated or analyzed data during this study have been included in this published article.

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, Kochi Medical School, Kochi University, Oko-Cho, Kohasu, Nankoku, Kochi, 783-8505, Japan

    Tomohiro Matsumoto, Rika Yoshimatsu, Marina Osaki, Kana Miyatake & Takuji Yamagami

  2. Department of Radiology, Kochi Health Sciences Center, 2125-1 Ike, Kochi, 781-0111, Japan

    Marina Osaki

  3. Department of Palliative Medicine, Kochi Medical School, Kochi University, Kohasu, Nankoku, Kochi, Oko-Cho, 783-8505, Japan

    Noriko Kitaoka

  4. Department of Diagnostic Radiology, International Medical Centre, Saitama Medical University, 1397-1 Yamane, Hidaka, 350-1298, Japan

    Yasutaka Baba

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  1. Tomohiro Matsumoto
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Tomohiro Matsumoto, Marina Osaki, and Rika Yoshimatsu. The first draft of the manuscript was written by Tomohiro Matsumoto, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Tomohiro Matsumoto.

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Matsumoto, T., Yoshimatsu, R., Osaki, M. et al. Percutaneous splanchnic nerve neurolysis analgesic efficacy and safety for cancer-related pain: a systematic review and meta-analysis. Support Care Cancer 31, 324 (2023). https://doi.org/10.1007/s00520-023-07746-y

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