Single-needle Celiac Plexus Block 

1997 ◽  
Vol 87 (6) ◽  
pp. 1301-1308 ◽  
Author(s):  
Marcello De Cicco ◽  
Mira Matovic ◽  
Luca Balestreri ◽  
Augusto Fracasso ◽  
Sandro Morassut ◽  
...  
Keyword(s):  
Pain Relief ◽  
Celiac Artery ◽  
Celiac Plexus ◽  
Celiac Plexus Block ◽  
Ct Guided ◽  
Needle Position ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Plexus Block

Background The "single-needle" celiac plexus block is becoming a popular technique. Despite different approaches and methods used to place the needle, the success of the block depends on adequate spread of the injectate in the celiac area. In the present retrospective study, the influence of needle tip position in relation to the celiac artery on injectate spread was evaluated. Methods Among 138 cancer patients subjected, via an anterior approach, to computed tomography (CT)-guided single-needle neurolytic celiac plexus block, a radiologist, blinded to the aim of the study, retrospectively selected 53 cases with normal anatomy of the celiac area as judged by CT. The decision was based on images obtained before the block. Patients were then classified into either group A (29 patients), in whom the needle tip was caudad to the celiac artery, and group B (24 patients), in whom it was cephalad. To evaluate CT patterns of neurolytic (mixed with contrast) spread, the celiac area was divided on the frontal plane into four quadrants: upper right and left and lower right and left, as related to the celiac artery. Patient assessments by visual analog scale were reviewed to evaluate the degree of pain relief. Pain relief 30 days after block was judged as long-lasting. The patterns of contrast spread in relation to the needle position and pain relief according to the number of quadrants with contrast were analyzed. Results The percentage of cases with four quadrants with contrast was higher when the needle tip was cephalad (58%, group B) than when it was caudad (14%, group A) to the celiac artery (P < 0.01). The percentage of patients with four and three quadrants with contrast was also higher in group B at 79% than in group A at 38% (P < 0.01). A significant difference in long-lasting pain relief was observed between patients with four quadrants with contrast (18 of 18, 100%; 95% confidence interval [CI], 81-100%) and patients with three quadrants with contrast (5 of 12, 42%; 95% CI, 15-72%) (P < 0.01). No patients showing two or one quadrant with contrast had long-lasting pain relief. Conclusions These findings suggest that, when the celiac area is free from anatomic distortions, and the single-needle neurolytic celiac plexus block technique is used, the needle tip should be positioned cephalad to the celiac artery to achieve a wider neurolytic spread. It also appears that only a complete (four quadrants) neurolytic spread in the celiac area can guarantee long-lasting analgesia.

Celiac Plexus Block

2001 ◽  
Vol 94 (4) ◽  
pp. 561-565 ◽  
Author(s):  
Marcello De Cicco ◽  
Mira Matovic ◽  
Roberto Bortolussi ◽  
Franco Coran ◽  
Dario Fantin ◽  
...  
Keyword(s):  
Pain Relief ◽  
Confidence Interval ◽  
Anterior Approach ◽  
Frontal Plane ◽  
Inverse Correlation ◽  
Celiac Artery ◽  
Celiac Plexus ◽  
Celiac Plexus Block ◽  
Ct Guided ◽  
Plexus Block

Background The success of the neurolytic celiac plexus block, despite different approaches and methods used, depends on adequate spread of the injectate in the celiac area. This retrospective study was conducted to evaluate the patterns of alcohol spread and pain relief in patients with cancer or therapy-related anatomic distortion of the celiac area. Methods From 177 cancer patients who underwent computed tomography (CT)-guided single-needle neurolytic celiac plexus block via an anterior approach, a radiologist, blind to the aim of the study, retrospectively selected 105 patients with abnormal anatomy of the celiac area as judged by CT images obtained before the block. To evaluate CT patterns of neurolytic (mixed with contrast) spread, the celiac area was divided on the frontal plane into four quadrants: upper right and left and lower right and left, as related to the celiac artery. Results were expressed as the number of quadrants into which contrast spread, ie., four, three, two, or one quadrants with contrast. The patterns of contrast spread according to the number of quadrants with anatomic distortion were analyzed. Patient assessment by visual analog scale was reviewed to evaluate the degree of pain relief. Pain relief 30 days after block was considered long-lasting. Pain relief at 30 days after block was analyzed according to the number of quadrants with contrast. Results Overall, four, three, two, and one quadrants with contrast were observed in 9 (8%), 21 (20%), 49 (47%), and 26 (25%) patients, respectively. An inverse correlation was observed between the number of quadrants with anatomic distortion and the number of quadrants with contrast (P < 0.001). Long-lasting pain relief was noticed in nine of nine patients (100%; 95% confidence interval, 66-100) with contrast in four-quadrants, and in 10 of 21 patients (48%; 95% confidence interval, 26-70) with contrast in 3 quadrants (P < 0.01). None of the 75 patients with contrast in two quadrants or one quadrant experienced long-lasting pain relief. Conclusions These findings suggest that, using the single-needle anterior approach, the neurolytic spread in the celiac area is highly hampered by the regional anatomic alterations. It also appears that only a complete (four quadrants) neurolytic spread in the celiac area can guarantee long-lasting analgesia, and that this picture may be obtained in a very limited fraction of patients with regional anatomic alterations.

CT-Guided Celiac Plexus Block with Absolute Alcohol: the Anterior Approach

1997 ◽  
Vol 37 (1) ◽  
pp. 101
Author(s):  
Jeong Min Lee ◽  
Mi Suk Lee ◽  
Young Ik Jang ◽  
Jeong Hoi Kim ◽  
Seong Hee Ym ◽  
...  
Keyword(s):  
Anterior Approach ◽  
Celiac Plexus ◽  
Celiac Plexus Block ◽  
Absolute Alcohol ◽  
Ct Guided ◽  
Plexus Block

Ultra-low-dose CT-guided lung biopsy in clinic: radiation dose, accuracy, image quality, and complication rate

2020 ◽  
pp. 028418512091762
Author(s):  
Ting Liang ◽  
Yonghao Du ◽  
Chenguang Guo ◽  
Yuan Wang ◽  
Jin Shang ◽  
...  
Keyword(s):  
Image Quality ◽  
Radiation Dose ◽  
Complication Rate ◽  
Lung Biopsy ◽  
Ct Guided ◽  
Significant Difference ◽  
Group A ◽  
Mode Group ◽  
Dose Accuracy ◽  
Group B

Background Computed tomography (CT)-guided percutaneous lung biopsy is usually performed by helical scanning. However, there are no studies on radiation dose, diagnostic accuracy, image quality, and complications based on axial scan mode. Purpose To determine radiation dose, accuracy, image quality, and complication rate following an ultra-low-dose (ULD) protocol for CT-guided lung biopsy in clinic. Material and Methods A total of 105 patients were enrolled to receive CT-guided lung biopsy. The use of an ULD protocol (axial scan) for CT-guided biopsy was initiated. Patients were randomly assigned to axial mode (Group A) and conventional helical mode (Group B) CT groups. 64-slice CT was performed for CT-guided pulmonary biopsy with an 18-G coaxial cutting biopsy needle. The radiation dose, accuracy, image quality, and complication rate were measured. Results Ninety-seven patients were selected for the final phase of the study. There was no significant difference between the two groups for pulmonary nodule characteristics ( P > 0.05). The mean effective dose in group A (0.077 ± 0.010 mSv) was significantly reduced relative to group B (0.653 ± 0.177 mSv, P < 0.001). There was no significant difference in accuracy, image quality, and complication rate ( P > 0.050) between the two modes. Conclusion An ULD protocol for CT-guided lung nodule biopsy yields a reduction in the radiation dose without significant change in the accuracy, image quality, and complication rate relative to the conventional helical mode scan.

CT Guided Celiac Plexus Block

1987 ◽  
Vol 20 (1) ◽  
pp. 84
Author(s):  
Jong Il Kim ◽  
No Cheon Park ◽  
Joon Seock Go ◽  
Byung Woo Min
Keyword(s):  
Celiac Plexus ◽  
Celiac Plexus Block ◽  
Ct Guided ◽  
Plexus Block

Efficacy of Neurolytic Celiac Plexus Block in Varying Locations of Pancreatic Cancer

2000 ◽  
Vol 92 (2) ◽  
pp. 347-347 ◽  
Author(s):  
Jan J. Rykowski ◽  
Maciej Hilgier
Keyword(s):  
Computed Tomography ◽  
Pancreatic Cancer ◽  
Pain Relief ◽  
Celiac Plexus ◽  
Celiac Plexus Block ◽  
Head Of The Pancreas ◽  
Group 2 ◽  
Effective Pain Relief ◽  
Plexus Block ◽  
Group 1

Background Neurolytic celiac plexus block (NCPB) is an effective way of treating severe pain in some patients with pancreatic malignancy. However, there are no studies to date that evaluate the effectiveness of NCPB related to the site of primary pancreas cancer. The aim of the study was to assess the effectiveness of NCPB in pancreatic cancer pain, depending on the location of the pancreatic tumor. Methods The prospective study was conducted in 50 consecutive patients diagnosed with pancreatic cancer. The patients were categorized into two different groups depending on tumor localization: group 1: patients with the cancer of the head of the pancreas and group 2: patients with the cancer of the body and tail of the pancreas. The qualitative and quantitative pain analyses were performed before and after NCPB. The patients underwent prognostic celiac plexus block with bupivacaine, followed by neurolysis during fluoroscopic control within the next 24 h. Results After NCPB, 37 patients (74%) had effective pain relief during the first 3 months or until death. Of the 37 patients who had effective pain relief, 33 (92%) were from group 1 and 4 (29%) were from group 2. In the remaining 13 patients (3 patients from group 1 and 10 patients from group 2), pain relief after NCPB was not satisfactory. Those patients were scheduled for repeated retrocrural neurolysis during computed tomography control. Computed tomography showed massive growth of the tumor around the celiac axis with metastases. After repeated neurolysis, pain relief clinically still was not satisfactory, necessitating additional opioid treatment. Conclusion In this study, unilateral transcrural celiac plexus neurolysis has been shown to provide effective pain relief in 74% of patients with pancreatic cancer pain. Neurolysis was more effective in cases with tumor involving the head of the pancreas. In the cases with advanced tumor proliferation, regardless of the technique used, the analgesic effects of NCPB were not satisfactory.

scholarly journals Pleural Effusion After CT-Guided Alcohol Celiac Plexus Block

1987 ◽  
Vol 66 (9) ◽  
pp. 911???912 ◽  
Author(s):  
Yoshihisa Fujita ◽  
Masuhiko Takaori
Keyword(s):  
Pleural Effusion ◽  
Celiac Plexus ◽  
Celiac Plexus Block ◽  
Ct Guided ◽  
Plexus Block
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