Endoscopic-ultrasound-guided celiac plexus neurolysis, Pancreatic cancer, Opioid withdrawal"/> A Case of Pancreatic Cancer and Opioid Withdrawal after Endoscopic Ultrasound-guided Celiac Plexus Neurolysis
Korean J Gastrointest Endosc > Volume 42(5); 2011 > Article
Korean Journal of Gastrointestinal Endoscopy 2011;42(5): 323-326.
내시경초음파 유도하 복강신경얼기 박리술 시행 후 마약 금단증상을 보인 췌장암 1예
설수환ㆍ김현수ㆍ황병식ㆍ오대명ㆍ백인엽ㆍ박민규ㆍ류현욱ㆍ권종규
대구파티마병원 소화기내과
A Case of Pancreatic Cancer and Opioid Withdrawal after Endoscopic Ultrasound-guided Celiac Plexus Neurolysis
Soo Hwan Seol, M.D., Hyun Soo Kim, M.D., Byung Sik Hwang, M.D., Dae Myung Oh, M.D., In Yub Baek, M.D., Min Kyu Park, M.D., Hyon Uk Ryu, M.D. and Jong Kyu Kwon, M.D.
Department of Gastroenterology, Fatima Hospital, Daegu, Korea
Abstract
Pancreatic cancer is usually unresectable upon diagnosis, and treatment aims to optimize the quality of the patient's life by managing symptoms, and, particularly, by providing adequate pain control. When the pain is refractory to opioids, interventions such as celiac plexus neurolysis (CPN) can be considered. Endoscopic ultrasound (EUS)-guided CPN has been introduced for pancreatic cancer. Reported herein is a case of a 75 year-old man with pancreatic cancer who was treated with opioids due to severe abdominal pain. EUS-guided CPN was performed for pain control, and the opioid administration was discontinued as the pain improved dramatically. However, the patient experienced opioid withdrawal symptoms, including anxiety, insomnia, nausea, and vomiting. Thus, although EUS-guided CPN successfully reduced pain in a patient undergoing such treatment and to whom opioid was administered, opioid administration should not be abruptly discontinued. Rather, the opioid dose should be reduced gradually to avoid drug withdrawal. (Korean J Gastrointest Endosc 2011;42:323-326)
Key Words: Endoscopic-ultrasound-guided celiac plexus neurolysis, Pancreatic cancer, Opioid withdrawal
주요어: 내시경초음파 복강신경얼기 박리술, 췌장암, 마약금단증상
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