Computed Tomography (CT) Simulated Fluoroscopy-Guided Transdiscal Approach in Transcrural Celiac Plexus Block.
10.3344/kjp.2013.26.4.396
- Author:
Yu Gyeong KONG
1
;
Jin Woo SHIN
;
Jeong Gill LEEM
;
Jeong Hun SUH
Author Information
1. Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. paindrsuh@gmail.com
- Publication Type:Brief Communication
- Keywords:
celiac plexus block;
CT simulated fluoroscopy-guided;
transcrural approach;
transdiscal approach
- MeSH:
Aorta;
Celiac Plexus;
Humans;
Intervertebral Disc;
Kidney;
Male;
Middle Aged;
Needles;
Pancreatic Neoplasms;
Spine
- From:The Korean Journal of Pain
2013;26(4):396-400
- CountryRepublic of Korea
- Language:English
-
Abstract:
Conventional transcrural CPB via the "walking off" the vertebra technique may injure vital organs while attempting to proximally spread injectate around the celiac plexus. Therefore, we attempted the CT-simulated fluoroscopy-guided transdiscal approach to carry out transcrural CPB in a safer manner, spreading the injectate more completely and closely within the celiac plexus area. A 54-year-old male patient with pancreatic cancer suffered from severe epigastric pain. The conventional transcrural approach was simulated, but the needle pathway was impeded by the kidney on the right side and by the aorta on the left side. After simulating the transdiscal pathway through the T11-12 intervertebral disc, we predetermined the optimal insertion point (3.6 cm from the midline), insertion angle (18 degrees), and advancement plane, as well as the proper depth. With the transdiscal approach, we successfully performed transcrural CPB within a narrow angle, and the bilateral approach was not necessary as we were able to achieve the bilateral spread of the injectate with the single approach.
