Efficacy and Outcomes of Interventional Procedures in Cancer Pain Management: A Retrospective Cohort Study

Abstract

Background: There is a lack of evidence for interventional procedures used in opioid-resistant cancer pain. To determine the effect of interventional procedures on pain, function, distress, and opioid consumption to improve understanding of their role in cancer pain.

Methods: 74 patients who received interventional procedures as an inpatient or outpatient for cancer pain between 2021 – 2022 were included. Primary outcomes included pain and opioid consumption. For inpatients receiving palliative care management, secondary outcomes were function, and distress associated with pain. These were measured pre-intervention, day of intervention and three months post-intervention.

Results: Most patients had palliative management (67.6%) and pancreatic cancer (23.0%). There were 94.5% of patients who received a temporary peripheral block, neuraxial block or a sympathetic block. Pain was most commonly experienced in the lower limbs (43.2%) and abdomen (33.8%). For inpatients, there was a reduction in pain scores, reduction in distress and maintenance of function post-intervention although these results were insignificant.

Overall oMEDD increased in this group (p < 0.05). For outpatients, there was insufficient data to assess pain, function and distress but there was a decrease in regular oMEDD post- intervention (p > 0.05).

Conclusion: In inpatients, interventions reduced pain, maintained function, and reduced distress associated with pain in palliative patients although most of these results were statistically insignificant. Significant increase in inpatient oMEDD may be consistent with progression of disease. Conversely, decrease in outpatient oMEDD may suggest a more stable disease course in this group, who could benefit from earlier interventions for opioid sparing reasons.