The effects of alcohol celiac plexus block, pain, and mood on longevity inpatients with unresectable pancreatic cancer: A double-blind, randomized, placebo-controlled study

Objective. This additional analysis of data from a previously reported pros pective trial comparing the effect of intraoperative alcohol or saline plac ebo neurolytic block in patients with pancreatic cancer was conducted in re sponse to the development of a new theory, which explores the relationship of negative mood states to pain, pain-related behavior, and ultimately, lon gevity. Methods. The original study used a double-blind procedure to randomly assig n 139 patients with histologically proven, unresectable pancreatic cancer t o receive either an alcohol or a saline block. Data on visual analog pain, mood, and interference with activity were collected preoperatively and ever y 2 months postoperatively until death. The current analysis was conducted on the complete data sets received from 130 patients. Demographic data were submitted to chi-square analysis and to univariate and multivariate analys is of variance. Univariate and multivariate analyses of variance also compa red I) the effect of alcohol versus saline on pain, mood, interference of p ain with activities, and longevity and 2) the impact of mood on pain with l ongevity as the dependent variable. Correlation and regression analyses exa mined the impact of mood on life expectancy. Results. The alcohol intervention had a significant positive effect on life duration and mood scores. High negative mood states correlated significant ly with an increase in visual analog pain, the rating of pain intensity at its worse, and pain interference with patients' activities. Conclusion. In these subjects, the neurolytic block, as compared with medic al management alone, improved pain, elevated mood, reduced pain interferenc e with activity, and was associated with an increase in life expectancy.