ABSTRACT
Celiac plexus neurolysis is considered an effective technique for relieving abdominal cancer pain. CT yields accurate anatomical detailing, thus allowing the indirect location of the celiac plexus and the planning of needle trajectory and positioning. September 1992 to December 1993, twenty-eight celiac plexus neurolyses for pain relief were performed in 26 patients (13 men and 13 women), 17 through the anterior and 11 through the posterior access. These patients had been referred to our department for pain management. Forty-eight hours after alcoholization, 20 patients (71%) had complete pain regression and their analgesic treatment was thus discontinued. 36% of the patients did not need any analgesics for 30 to 169 days. No neurologic complications were observed. Only transient orthostatic hypotension requiring no treatment developed in all our patients during the first 24 hours after the block. To conclude, we believe celiac plexus alcoholization under CT guidance to be a safe and effective technique for relieving abdominal pain due to cancer or benign conditions. We prefer the anterior approach because it is better accepted by the patients and more easily performed by the operators.
