Chest pain following oesophageal stenting for malignant dysphagia

AIM: The palliative use of self-expanding metallic stents has been widely r eported to relieve dysphagia in cases of oesophageal carcinoma. Little has been documented on the severity of chest pain following oesophageal stentin g. The aim of this study was to investigate the association of pain with oe sophageal stenting for malignant dysphagia, METHODS: Fifty-two patients with inoperable oesophageal carcinoma underwent stent placement between 1995-1999, Daily opioid analgesic requirements (mg of morphine equivalent doses) were monitored for 3 days before and 7 days after stenting, The degree of palliation was expressed as a dysphagia score (0-3), Hospital stay, readmission days, stent complications and patient su rvival time were also recorded. RESULTS: Twenty-six patients (50%) required opioid analgesia for chest pain (median dose: 80 mg morphine/day) within 48 h of the procedure compared to 11 (21.2%) patients before stenting (P = 0,0041), A significant increase w as evident in the analgesic consumption following stent deployment (P < 0,0 01), The dysphagia score improved by a median value of 1 (CI 0,25) P < 0,00 1, with a re-intervention rate of 11,5%, The median survival time was 40 da ys post stenting (range 1-120), CONCLUSION: A significant proportion of patients developed chest pain after oesophageal stenting, requiring high dose opioid analgesia. As the origin of the pain is still unknown, pre-emptive analgesia may a play role in redu cing stent-related morbidity and possibly in-hospital stay. (C) 2001 The Ro yal College of Radiologists.