J Korean Med Sci.  2000 Apr;15(2):173-178. 10.3346/jkms.2000.15.2.173.

CT-guided celiac plexus block for intractable abdominal pain

• Lee JM

• KMID: 648119
• DOI: http://doi.org/10.3346/jkms.2000.15.2.173

Abstract

Treatment of intractable abdominal pain due to inoperable intraabdominal malignancy is important, and the ineffectiveness of pharmacological agents has led many investigators to recommend chemical neurolysis of the celiac ganglions as a treatment. The author describes the technique and results of celiac plexus neurolysis under CT-guidance with various approach routes, including anterior, posterior and transaortic routes. Twenty-eight patients, ranging in age from 36 to 82 years, have been treated with this procedure. All had inoperable or recurred intraabdominal malignancies and suffered from intractable upper abdominal pain and/or back pain. The author performed the procedure using absolute alcohol by an anterior approach (n=18), posterior approach (n=6) and transaortic approach (n=4). Pain was rated according to a visual analog scale before and after the procedure to gauge treatment success. No major complications occurred. Mild hypotension occurred in five patients (18%) and transient diarrhea in six patients (21%). Twenty-one (75%) of the 28 patients had some relief of pain and 17 of these patients (61%) had good relief of pain after the procedure. The results support that CT-guided celiac plexus block with alcohol is a safe and effective means of pain control in patients with intraabdominal malignancy.

Keyword

Anesthesia; Celiac Plexus; Tomography, X-Ray Computed; Abdominal Pain; Radiography, Interventional

MeSH Terms

Abdominal Pain/therapy*
Adult
Aged
Aged, 80 and over
Celiac Plexus/surgery*
Celiac Plexus/radiography
Female
Human
Male
Middle Age
Needles
Nerve Block/methods*
Pain, Intractable/therapy*
Radiography, Interventional
Tomography, X-Ray Computed*