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Related Experiment Videos

A modified approach to transcrural celiac plexus block.

Ian Y Yang1, Saeed Oraee

  • 1Department of Anesthesiology and Pain Medicine, Bronx-Lebanon Hospital Center, Our Lady of Mercy Medical Center, Bronx, NY, USA. iyangmd@yahoo.com

Regional Anesthesia and Pain Medicine
|May 18, 2005
PubMed
Summary

This study presents a modified transcrural celiac block technique using computed tomography (CT) imaging. The novel approach enhances safety by avoiding bone contact and reducing the risk of vital organ puncture during pain management for pancreatic cancer.

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Area of Science:

  • Interventional Radiology
  • Pain Management
  • Oncology

Background:

  • Transcrural celiac block is used for pancreatic cancer pain.
  • The traditional "walking off" the L1 vertebra technique carries risks of complications.
  • Patient-specific computed tomography (CT) imaging can potentially improve procedural safety.

Observation:

  • A 63-year-old woman with refractory pancreatic cancer pain underwent a modified celiac block.
  • CT imaging guided needle placement, avoiding the L1 vertebra and surrounding organs.
  • Measurements included needle entry points, angles, and depth relative to the L1 vertebra and celiac trunk.

Findings:

  • The modified technique successfully guided needle placement without bony contact or redirection.
  • Contrast confirmed accurate placement and silhouetted the target vasculature.

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  • The patient experienced significant pain relief, with visual analog scale scores improving to 0-1/10.

    • Implications:

    • This CT-navigated technique offers a safer alternative to traditional methods for transcrural celiac blocks.
    • It reduces the likelihood of complications such as bone injury and organ puncture.
    • This approach may improve outcomes for patients with refractory cancer pain.