Abstract:
Celiac plexus neurolysis is adjunct modality to relieve intractable pain caused by upper abdominal malignancy. An anterior approach offers advantages including shorter procedure time, less discomfort and less risk of neurological complications. The CT and ultrasound help to improve visualization of the celiac plexus. Their use allow accurate needle placement and reduce the risks. We report our experience with sonographically guided anterior approach to celiac plexus neurolysis in upper abdominal malignancy patients. Methodology: Patients with upper abdominal malignancy with VAS ≥3 not responding to diclofenac and demanding additional opioids or those having adverse effects were included. A prognostic block was performed under deep sedation with sonographic guidance using 22G, 15cm long Chiba needle advanced through biopsy guide to the preaortic zone above takeoff of celiac artery. Thirty to forty ml of 50% alcohol was injected. The VAS scores, analgesic consumption, duration of complete and partial pain relief were assessed at one hour, 24 hours, one week, one month, two month and three month intervals. Results: Fifteen patients were enrolled There was statistically significant decrease in mean VAS score at 1st hour, 24th hour, 1st week, 1st, 2nd and 3rd month respectively (p
Page(s):
274-281
DOI:
DOI not available
Published:
Journal: Anaesthesia, Pain and Intensive Care, Volume: 19, Issue: 3, Year: 2015