[Appropriate puncture site for CT monitored celiac plexus block determined from CT films]

We investigated appropriate puncture site, angle of needle entry, and the distance of the insertion for CT monitored celiac plexus block using CT photograms on prone position in sixteen patients with gastrointestinal diseases. In retrocrural approach during CT monitored celiac plexus block, the average distances of puncture sites to midline were 3.84 cm on the right and 4.06 cm on the left, and the average needle angles were 74.1 degrees on the right and 76.9 degrees on the left. The average depths from the puncture site to marked position in retrocrural space were 7.88 cm on the right and 7.85 cm on the left. The rates of predicted organ puncture when needle is inserted 7 cm lateral to the midline of the spinal process were 43.8 percent in the right lung, 12.5 percent in the left lung, 56.2 percent in the right kidney and 68.8 percent in the left kidney. From these results, we found high possibilities of organ injuries using the conventional technique for celiac plexus block. We conclude that we could perform celiac plexus block more safely and surely using the retrocrural approach by CT monitoring, as serious complications are avoidable by viewing ideal puncture course on CT photographs.