Computed Tomography Versus Fluoroscopy Guidance in Antecrural Celiac Plexus Block
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- Category: Vol. 83, September 2015
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Computed Tomography Versus Fluoroscopy Guidance in Antecrural Celiac Plexus Block, KHALED ABD EL-HAMEED, IKRAM H. MAHMOUD, AZZA F. OMRAN, AHMED SHAKER and SUZAN ADLAN
Abstract
Background: Celiac plexus block has been performed by an anterior or posterior approach. The posterior approach can be either for antecrural or retrocrural space. Antecrural site refers to the injection of neurolytic agent into the space anterior to the diaphragmatic crura and aorta. The antecrural space is the most common site of neurolytic agent injection and is highly effective in achieving pain control because injection into this space directly destroys the celiac plexus where it is most concentrated, and minimizes the risk of somatic nerve roots block, which is associated with retrocrural approach. The purpose of this study is to highlight differences between two techniques as regard Time of doing each technique from its beginning to the end and any complications occurred.
Methods: 60 patients with pancreatic cancer pain for which pharmacological treatment (NSAIDs and opioids) proved either ineffective or limited by side effects were randomly allocated into two groups. Study was done over eighteen months from January 2013 to June 2014. Each patient is assessed by Time of doing each technique from its beginning (needle insertion) to the end and any complications have been recorded.
Results: The parameters were comparable with significant difference between both techniques (p-value !90.05) regarding time consumed and there were no statistical significance regarding complications which occurred in both procedures.
Conclusion: We concluded CT scanning is useful to define the retroperitoneal anatomy especially when anatomic relations of the retroperitoneal organs are distorted by tumor or previous operations limiting time consumed during the procedure. However the technique does not seem important in results or complications.