Effectiveness of fluoroscopy-guided lytic inhibition of splanchnic nerves with phenol at 2 levels versus 1 level in upper abdominal visceral pain

Objective: To determine the effectiveness of phenol-based lytic inhibition of the splanchnic nerves at two levels versus one level, guided by fluoroscopy, in patients with upper hemi-abdominal visceral cancer pain. Materials and Methods: A retrospective, observational, descriptive, cross-sectional study was conducted on patients with upper hemi-abdominal visceral cancer pain treated at the Pain Clinic of the National Cancer Institute, Mexico. Statistical analysis was performed using SPSS V25.0. Results: Pain reduction was evaluated in 85 patients who underwent INE (65 at one level and 20 at two levels). Most patients experienced a short-term reduction in pain intensity (2 hours and 1 week) assessed using the ENA scale, with a decrease of 1 to 3 points in one-level INE and 2 to 3 points in two-level INE. In the long term, some patients maintained analgesia, with an average reduction of 4 points at one month and 3 points at three months in both groups. Opioid consumption (MED) decreased post-procedure in both groups, with an average reduction of 11.02 mg/day in the one-level INE group and 24.7 mg/day in the two-level INE group. Additionally, patients reported high levels of satisfaction (Likert Scale 4/5 or 5/5). Conclusions: The procedure is equally effective for patients undergoing one-level or two-level lytic INE. Pain control was greater in the group of patients treated with a two-level approach, as reflected in post-procedure MED, which showed a greater reduction in patients undergoing two-level INE. The satisfaction level was classified as satisfied or very satisfied, indicating that performing this procedure at either one or two levels is useful for controlling visceral cancer pain. Keywords: Cancer pain, lytic inhibition, splanchnic nerves