Alternative Method of Retrocrural Approach during Celiac Plexus Block Using a Bent Tip Needle.
10.3344/kjp.2015.28.2.109
- Author:
Ji Won AN
1
;
Eun Kyeong CHOI
;
Chol Hee PARK
;
Jong Bum CHOI
;
Dong Kyun KO
;
Youn Woo LEE
Author Information
1. Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea. YWLEEPAIN@yuhs.ac
- Publication Type:Original Article
- Keywords:
Bent tip needle;
Celiac plexus block;
Fluoroscopy;
Retrocrural approach;
Visceral pain
- MeSH:
Celiac Plexus*;
Fluoroscopy;
Humans;
Needles*;
Punctures;
Skin;
Tomography, X-Ray Computed;
Visceral Pain
- From:The Korean Journal of Pain
2015;28(2):109-115
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: This study sought to determine safe ranges of oblique angle, skin entry point and needle length by reviewing computed tomography (CT) scans and to evaluate the usefulness of a bent tip needle during celiac plexus block (CPB). METHODS: CT scans of 60 CPB patients were reviewed. Image of the uppermost margin of L2 vertebral body was used to measure the minimal and maximal oblique angles and the distances from the midline to skin puncture point. The imaginary needle trajectory distance was calculated by three-dimensional measurement. When the procedure was performed by using a 10degrees bent tip needle under a 20degrees oblique X-ray fluoroscopic view, the distance (GF/G'F) from the midline to the actual puncture site was measured. RESULTS: The imaginary safe oblique angle range was 26.4-34.2degrees and 27.7-36.0degrees on the right and left, respectively. The distance from the midline to skin puncture point was 6.1-7.6 cm on the right and 6.3-7.6 cm on the left. The needle trajectory distance at minimal angle was 9.6-11.6 cm on the right and 9.5-11.5 cm on the left. The distance of GF/G'F was 5.1-6.5 cm and 5.0-6.4 cm on the right and left, respectively. All imaginary parameters were correlated with BMI except for GF/G'F. All complications were mild and transient. CONCLUSIONS: We identified safe values of angles and distances using a straight needle. Furthermore, using a bent tip needle under a 20degrees oblique fluoroscopic view, we could safely perform CPB with smaller parameter values.
