EVALUATION OF THE EFFECTS OF CT- GUIDED NEUROLYTIC CELIAC BLOCK FOR MANAGING INTRACTABLE UPPER ABDOMINAL PAIN

The purpose of this study was to evaluate the therapeutic result of CT-guided celiac plexus block for managing intractable upper abdominal pain due to pancreatic carcinoma or chronic pancreatitis. We treated 22 cancer patients who were on regular narcotic medication. After an N infusion of 10mL/kg Ringer's lactate solution, all patients were rolled onto prone position, and lidocaine was used to infiltrate the skin and subcutaneous tissues. Then CT guided injection of the celiac plexus was performed with 25 mL 50% ethyl alcohol with 0.25% bupivacaine. Vital signs, quality of analgesia and any adverse effects were recorded. The age range of our patients was 68.63±7.48 years and weight was 64.68±7.54 kg (mean±SD). All patients had a history of abdominal operation due to disease and also a history of morphine injection due to pain. In 100% of our patients, sedation in the first hour was gained; excellent pain relief was achieved in 86.4% of cases during the first 24 hours after the procedure. No serious complications occurred in the study, a 30% drop in systolic blood pressure or even more was found in 13.6% of the cases, while nausea and transient orthostatic hypotension requiring no treatment developed in 31.8% and 100% of the cases respectively, and mild diarrhea was reported in 18.1% of the cases for two weeks. CT-guided neurolytic celiac block appears to be a safe and effective technique for relieving abdominal pain due to cancer.