Coldwell D M, Loper K A
Department of Radiology, University of Washington Medical Center, Seattle 98195.
Radiology. 1989 Sep;172(3 Pt 2):1039-40. doi: 10.1148/172.3.1039.
Hepatic arterial embolization (HAE) has been utilized for treatment of unresectable primary and metastatic hepatic malignancies. While palliation results from this procedure, one of the major drawbacks to its use is the immediate short-term side effects, especially the right upper quadrant and epigastric pain experienced by all patients. High doses of intravenous narcotics have been used for pain control. The data on 18 patients who received a celiac plexus block immediately prior to 31 HAE procedures were compared with those on 19 control patients who underwent 42 HAE procedures without celiac plexus block. All patients who received a celiac plexus block had relief of pain without requiring intravenous analgesic both during the procedure and for the first 8 hours after HAE. These patients also subsequently received substantially lower dosages of analgesics than the control subjects. Two patients had transient hypotension due to the celiac plexus block, but no other complications occurred. It is recommended that patients undergoing HAE first receive a celiac plexus block for pain control.
肝动脉栓塞术（HAE）已被用于治疗无法切除的原发性和转移性肝恶性肿瘤。虽然该手术可带来姑息效果，但其主要缺点之一是会产生即刻的短期副作用，尤其是所有患者都会经历的右上腹和上腹部疼痛。高剂量静脉注射麻醉药已被用于控制疼痛。将18例在31次HAE手术前立即接受腹腔神经丛阻滞的患者的数据与19例接受42次未进行腹腔神经丛阻滞的HAE手术的对照患者的数据进行了比较。所有接受腹腔神经丛阻滞的患者在手术期间以及HAE术后的前8小时内均无需静脉注射镇痛药即可缓解疼痛。这些患者随后接受的镇痛药剂量也明显低于对照组。两名患者因腹腔神经丛阻滞出现短暂性低血压，但未发生其他并发症。建议接受HAE的患者首先接受腹腔神经丛阻滞以控制疼痛。
