Sympathetic intervention in abdominopelvic cancer pain: A systematic review and meta-analysis

This review aims to investigate the effectiveness of CP, SHP, and GI intervention as a singular or combination to reduce the pain intensity. Medline, Scopus, and CENTRAL databases were used to identify abstracts using predefined search terms. Risk of bias in non-randomized studies - of intervention...

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Main Authors: Made Agus Mahendra Inggas, Fandi Hendrawan, Amelia Marcelina, Kezia Aurelia Tamzil, Takaomi Taira
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:World Neurosurgery: X
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Online Access:http://www.sciencedirect.com/science/article/pii/S2590139725000602
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author Made Agus Mahendra Inggas
Fandi Hendrawan
Amelia Marcelina
Kezia Aurelia Tamzil
Takaomi Taira
author_facet Made Agus Mahendra Inggas
Fandi Hendrawan
Amelia Marcelina
Kezia Aurelia Tamzil
Takaomi Taira
author_sort Made Agus Mahendra Inggas
collection DOAJ
description This review aims to investigate the effectiveness of CP, SHP, and GI intervention as a singular or combination to reduce the pain intensity. Medline, Scopus, and CENTRAL databases were used to identify abstracts using predefined search terms. Risk of bias in non-randomized studies - of intervention tool and Cochrane risk-of-bias tool for randomized trials were applied for risk of bias assessment. This review includes only severe pain defined as visual analogue scale or numeric rating scale (NRS) 7–10. Fifteen articles were included in this study. In general, pain intensity was reduced significantly after the intervention (MD -4.58; 95 %CI -5.25 to −3.91). However, subgroup analysis failed to identify any significant reduction in ganglion Impar group. Regarding morphine consumption, the intervention was significantly subsided the need of morphine (SMD -1.31; 95 %CI -1.86 to −0.76). In meta-regression, follow-up period was significantly moderated the pain changes by increasing 0.43 score within a month after the intervention (p value < 0.01). The limitation of this study lies on the pain assessment that used NRS which is a self-reported evaluation and may lead to self-reported bias. In conclusion, the sympathetic intervention demonstrates its effectiveness in cancer pain. However, since GI intervention mostly failed to reduce the pain severity during the follow up, GI intervention should be used in combination with another intervention.
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spelling doaj-art-b427aa2fd70c443c890f05f49a487aef2025-08-20T03:12:57ZengElsevierWorld Neurosurgery: X2590-13972025-07-012710048610.1016/j.wnsx.2025.100486Sympathetic intervention in abdominopelvic cancer pain: A systematic review and meta-analysisMade Agus Mahendra Inggas0Fandi Hendrawan1Amelia Marcelina2Kezia Aurelia Tamzil3Takaomi Taira4Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Banten, Indonesia; Corresponding author. Faculty of Medicine, Universitas Pelita Harapan, Bencongan, Kelapa Dua, Tangerang Regency, Banten, 15810, Indonesia.Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Special Region of Yogyakarta, IndonesiaFaculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Special Region of Yogyakarta, IndonesiaFaculty of Medicine, Universitas Udayana, Denpasar, Bali, IndonesiaDepartment of Neurosurgery, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, JapanThis review aims to investigate the effectiveness of CP, SHP, and GI intervention as a singular or combination to reduce the pain intensity. Medline, Scopus, and CENTRAL databases were used to identify abstracts using predefined search terms. Risk of bias in non-randomized studies - of intervention tool and Cochrane risk-of-bias tool for randomized trials were applied for risk of bias assessment. This review includes only severe pain defined as visual analogue scale or numeric rating scale (NRS) 7–10. Fifteen articles were included in this study. In general, pain intensity was reduced significantly after the intervention (MD -4.58; 95 %CI -5.25 to −3.91). However, subgroup analysis failed to identify any significant reduction in ganglion Impar group. Regarding morphine consumption, the intervention was significantly subsided the need of morphine (SMD -1.31; 95 %CI -1.86 to −0.76). In meta-regression, follow-up period was significantly moderated the pain changes by increasing 0.43 score within a month after the intervention (p value < 0.01). The limitation of this study lies on the pain assessment that used NRS which is a self-reported evaluation and may lead to self-reported bias. In conclusion, the sympathetic intervention demonstrates its effectiveness in cancer pain. However, since GI intervention mostly failed to reduce the pain severity during the follow up, GI intervention should be used in combination with another intervention.http://www.sciencedirect.com/science/article/pii/S2590139725000602Sympathetic interventionMorphineCancer painMeta-analysisMeta-regression
spellingShingle Made Agus Mahendra Inggas
Fandi Hendrawan
Amelia Marcelina
Kezia Aurelia Tamzil
Takaomi Taira
Sympathetic intervention in abdominopelvic cancer pain: A systematic review and meta-analysis
World Neurosurgery: X
Sympathetic intervention
Morphine
Cancer pain
Meta-analysis
Meta-regression
title Sympathetic intervention in abdominopelvic cancer pain: A systematic review and meta-analysis
title_full Sympathetic intervention in abdominopelvic cancer pain: A systematic review and meta-analysis
title_fullStr Sympathetic intervention in abdominopelvic cancer pain: A systematic review and meta-analysis
title_full_unstemmed Sympathetic intervention in abdominopelvic cancer pain: A systematic review and meta-analysis
title_short Sympathetic intervention in abdominopelvic cancer pain: A systematic review and meta-analysis
title_sort sympathetic intervention in abdominopelvic cancer pain a systematic review and meta analysis
topic Sympathetic intervention
Morphine
Cancer pain
Meta-analysis
Meta-regression
url http://www.sciencedirect.com/science/article/pii/S2590139725000602
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