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ONE NEEDLE TRANS-AORTIC AND RETROCRURAL NEUROLYTIC CELIAC PLEXUS BLOCK FOR SEVERE UPPER ABDOMINAL CANCER PAIN. V. Whizar-Lugo, F. Anzorena-Vallarino, R. Estrada-Coronado, C. Solar-Labastida, C. Segovia-García, J. Saldaña-Huerta. Servicios Profesionales de Anestesiología y Medicina del Dolor
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ONE NEEDLE TRANS-AORTIC AND RETROCRURAL NEUROLYTIC CELIAC PLEXUS BLOCK FOR SEVERE UPPER ABDOMINAL CANCER PAIN V. Whizar-Lugo, F. Anzorena-Vallarino, R. Estrada-Coronado, C. Solar-Labastida, C. Segovia-García, J. Saldaña-Huerta Servicios Profesionales de Anestesiología y Medicina del Dolor Centro Médico del Noroeste Tijuana BC, México www.anestesia-dolor.org vwhizar@anestesia-dolor.org
One Needle,Trans-aortic and RetrocruralCeliac Plexus NeurolysisAim of the study • To investigate the usefulness of a single needle injection for a pre-aortic and retrocrural CPN in opioid resistant cancer pain patients, who have anatomy distortion • To determine the pre-crural and retro-crural neurolytic spread • To determine side effects and complications of this technique
Celiac plexus neurolysis techniquesAccording with anatomical approaches • POSTERIOR APPROACH • Retrocrural, Trans-crural, and Trans-aortic • ANTERIOR APPROACH • Trans-gastric and Trans-hepatic
Celiac plexus neurolysis techniques According with neddle placement • RETROCRURAL • Standard • Two needless with posterior approach • PRECRURAL • Posterior approach • Trans-aortic • Trans-crural • Anterior approach • Trans-hepatic • Trans-gastric • RETRO and PRECRURAL • Posterior approach • One needle technique
R e s u l t s Analgesia (VAS) and % Opiod Reduction
ONE NEEDLE CELIAC PLEXUS NEUROLYSIS TRANS-AORTIC AND RETROCRURAL • C o n c l u s i o n s • This technique is usefull in patients with opioid resistant/side effects upper abdominal cancer pain, who have anatomy distortion • It is a safe, and easy procedure • No neuro-vascular complications were seen • Satisfactory analgesia was achieved • Total opioid intake was reduced