Alkan Alpay, Durak Ahmet Candan, Ozcan Nevzat, Kutlu Ramazan, Baysal Tamer, Siğirci Ahmet
Inönü Universitesi Tip Fakültesi, Turgut Ozal Tip Merkezi, Radyoloji Anabilim Dali, Malatya.
Tani Girisim Radyol. 2003 Dec;9(4):456-61.
To investigate the effectiveness and safety of celiac ganglion blockade in cases with abdominal malignancies who are narcotic analgesic dependent for control of severe abdominal pain.
A total of 30 celiac ganglion blockades were performed in 27 patients between the ages of 19 and 75. A 22 G Chiba needle was placed through the percutaneous anterior approach into the celiac ganglion region under the guidance of CT, and 98% alcohol was administered. The procedure was repeated in three cases due to insufficient response.
In 24 (88.8%) of the 27 cases, the severity of pain decreased. Total relief of the pain was achieved in 13 (48.1%) cases. In 9 (33.3%) cases pain was controlled with non-narcotic analgesics. In 2 (7.4%) cases, the dose of the narcotic analgesic decreased. There was no change in the severity of the pain in 3 (11.1%) cases. Transient complications were diarrhea in 4 (14.8%), hypotension in 6 (22.2%) cases and hemiparesis in one (3.7%) case.
Celiac ganglion blockade through the percutaneous anterior approach under the guidance of CT should be preferred for the control of pain in the early periods in cases with abdominal malignancies, especially gastric and pancreatic, due to easy performance, safety, lower incidence of complications, high success rate and low cost.
探讨腹腔神经节阻滞对依赖麻醉性镇痛药控制严重腹痛的腹部恶性肿瘤患者的有效性和安全性。
对27例年龄在19至75岁之间的患者共进行了30次腹腔神经节阻滞。在CT引导下，通过经皮前路将22G千叶针置入腹腔神经节区域，并注入98%乙醇。3例因效果不佳而重复该操作。
27例患者中，24例（88.8%）疼痛程度减轻。13例（48.1%）疼痛完全缓解。9例（33.3%）患者使用非麻醉性镇痛药即可控制疼痛。2例（7.4%）患者麻醉性镇痛药剂量减少。3例（11.1%）患者疼痛程度无变化。短暂并发症包括腹泻4例（14.8%）、低血压6例（22.2%）、偏瘫1例（3.7%）。
对于腹部恶性肿瘤患者，尤其是胃癌和胰腺癌患者，在早期控制疼痛时，应首选在CT引导下经皮前路进行腹腔神经节阻滞，因其操作简便、安全、并发症发生率低、成功率高且成本低。
