Improved technique for CT-guided celiac ganglia block

Haaga, John R.; Kori, Shoichi; Eastwood, D. W.; Borkowski, Gregory P.

doi:10.2214/ajr.142.6.1201

Cited by 71 publications

(32 citation statements)

References 10 publications

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“…Im Jahr 1984 berichteten Haaga et al [4] über den verbesserten Zugang unter CT-Kontrolle. Eine Vielzahl von Berichten über die endosonographisch gesteuerte Blockade folgten [5,6].…”

Section: Ganglienblockade Neurolyse Des Plexus Coeliacusunclassified

Ganglienblockade

2015

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“…Im Jahr 1984 berichteten Haaga et al [4] über den verbesserten Zugang unter CT-Kontrolle. Eine Vielzahl von Berichten über die endosonographisch gesteuerte Blockade folgten [5,6].…”

Section: Ganglienblockade Neurolyse Des Plexus Coeliacusunclassified

Ganglienblockade

2015

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“…Our CT-guided technique for percutaneous needle and catheter insertion followed by confirmation of position by injection of radio-opaque contrast media produces a high success rate when compared with the landmark technique, but with low complications [16,17]. Once sympathetically maintained pain has been confirmed, neuroablative procedures can be performed via the catheter.…”

Section: Discussionmentioning

confidence: 99%

Interventional management of intractable sympathetically mediated pain by computed tomography‐guided catheter implantation for block and neuroablation of the thoracic sympathetic chain: technical approach and review of 322 procedures

et al. 2011

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SummaryWe retrospectively evaluated the safety and efficacy of computed tomography-guided placement of percutaneous catheters in close proximity to the thoracic sympathetic chain by rating pain intensity and systematically reviewing charts and computed tomography scans. Interventions were performed 322 times in 293 patients of mean (SD) age 59.4 (17.0) years, and male to female ratio 105:188, with postherpetic neuralgia (n = 103, 35.1%), various neuralgias (n = 88, 30.0%), complex regional pain syndrome (n = 69, 23.6%), facial pain (n = 17, 5.8%), ischaemic limb pain (n = 7, 2.4%), phantom limb pain (n = 4, 1.4%), pain following cerebrovascular accident (n = 2, 0.7%), syringomyelia (n = 2, 0.7%) and palmar hyperhidrosis (n = 1, 0.3%). The interventions were associated with a total of 23 adverse events (7.1% of all procedures): catheter dislocation (n = 9, 2.8%); increase in pain intensity (n = 8, 2.5%); pneumothorax (n = 3, 0.9%); local infection (n = 2, 0.6%); and puncture of the spinal cord (n = 1, 0.3%). Continuous infusion of 10 ml.h )1 ropivacaine 0.2% through the catheters decreased median (IQR [range]) pain scores from 8 (6-9 [2-10]) to 2 (1-3 [0-

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“…21 It accurately depicts diffusion of the neurolytic agent and real-time monitoring of the procedure ( Figure 6). Unfortunately not every procedure can be performed in the CT room 28 and there is high risk of radiation exposure.…”

Section: Clinical Studiesmentioning

confidence: 99%

Coeliac plexus neurolysis for upper abdominal malignancies using an anterior approach: review of the literature

Ghai

Kumar

Wadhera³

2015

Southern African Journal of Anaesthesia and Analgesia

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Background: Coeliac plexus neurolysis (CPN) helps to diminish pain arising from malignancy of upper abdominal viscera. Imaging modalities have increased the success rates by enhancing technical accuracy including fluoroscopy, computed tomography and ultrasound. Advancement in the imaging modalities used has helped in the accurate depiction of anatomy and position of the needle tip. Methods: In an anterior approach, the patient lies supine and the needle is inserted through the anterior abdominal wall into the retropancreatic space. The needle often traverses the stomach, liver or pancreas before reaching the coeliac plexus due to anatomical considerations. The literature has been reviewed regarding various imaging modalities using an anterior approach to coeliac plexus block with regard to success rate, improvement in pain scores, duration of pain relief and analgesic consumption. Results: Successful pain relief in abdominal malignancies with an anterior approach using various imaging modalities varies between 54% and 94% of patients. Following neurolysis, many patients can be weaned off opioids. This procedure improves quality of life and reduces the risk of drug-related side effects. The duration of pain relief after an anterior approach is six to eight weeks. Conclusion: The use of various imaging modalities in an anterior approach has improved the technical accuracy in reaching the coeliac plexus, thereby avoiding the needle piercing crucial structures and avoiding deposition of drug in the retrocrural space, thereby reducing the risk of neurological complications. Coeliac plexus neurolysis via an anterior approach using different imaging modalities does not completely abolish pain, rather it diminishes pain, helping to reduce opioid requirements and improving survival in patients with upper abdominal malignancy.

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Improved technique for CT-guided celiac ganglia block

Cited by 71 publications

References 10 publications

Ganglienblockade

Ganglienblockade

Interventional management of intractable sympathetically mediated pain by computed tomography‐guided catheter implantation for block and neuroablation of the thoracic sympathetic chain: technical approach and review of 322 procedures

Coeliac plexus neurolysis for upper abdominal malignancies using an anterior approach: review of the literature

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