Tei, Y., Morita, T., Nakaho, T., Takigawa, C., Higuchi, A., Suga, A., . . . Fujimoto, M. (2008). Treatment efficacy of neural blockade in specialized palliative care services in Japan: A multicenter audit survey. Journal of Pain and Symptom Management, 36(5), 461–467.doi: 10.1016/j.jpainsymman.2007.11.009
To ascertain the frequency of neural blockade in certified palliative care units and by palliative care teams; to determine the efficacy of neural blockade interventions and explore the predictors of successful interventions
Co-researchers from 120 certified palliative care units and 20 palliative care teams reported on all patients who received neural blockade for pain control 2002–2003.
Retrospective chart review
All types of neural blockade studied—epidural, plexus, and intrathecal—were associated with reduction in pain intensity, improvement in performance status, and decrease in opioid consumption. No type was associated with significant improvement in communication level or decrease in delirium. Groups receiving plexus block or epidural experienced an improvement in performance status. Patients in the epidural and intrathecal groups reduced use of opiods, but patients in the plexus block group did not.
Of patients receiving palliative care services in Japan, 3.8% required neural blockade for pain control. The percentage is similar in Western countries. Study findings suggest that neural blockade can decrease pain intensity, improve performance status, and decrease opioid consumption, without causing serious adverse effects. Of 19 patients who had a neural blockade, six showed a decrease in delirium.
Neural blockade may be a useful intervention for a select group of patients who are receiving inadequate pain control from traditional opioids.