Celiac plexus block with the long stylet needle technique

Abstract

Neurolytic celiac plexus block has been used successfully in the treatment of patients with intractable intra-abdominal pain due to malignancy or to benign pain syndromes. A new technique is described here for blocking the celiac plexus through the retrocrural approach with a special long stylet needle inserted under fluoroscopic guidance. Celiac blocks were performed in 2 groups of patients. In the first group (n=7), the classic technique was performed with the use of 2 needles; in the second group (n=5), 1 needle and 2 stylets were used to complete the block through the long guided needle approach. Parameters evaluated in each group consisted of the number of attempts, defined as the number of skin punctures, and fluoroscopy injection time, defined as time from the beginning offluoroscopy to completion of successful needle insertion into the celiac area. Patients who had abdominal pain resulting from pancreatic cancer underwent celiac plexus block performed by the long guided needle technique. In the classic technique group, fluoroscopy injection time was 13±3 min and the number of attempts was 5.3±3; values in the long guided needle group were 8.9±3 min and 4.9±2, respectively. The difference in fluoroscopy injection times was significant (P < .05). The long guided needle technique for celiac plexus block may be an effective and appropriate method for beginners or for practitioners who are not knowledgeable about imaging techniques used in various medical specialties.