Cariati M, Henriquet F, Fiorentini F, De Martini G, Pretolesi F, Roy M T, Martinoli C
I Divisione di Radiologia, Università di Genova.
Radiol Med. 1997 Jun;93(6):739-42.
CT-guided neurolytic splanchnic nerve block is a technique for relieving abdominal cancer pain; the goal is the alcoholic neurolytic interruption of the sensitive structures in retroperitoneal space. CT yields accurate anatomical detailing and the course for needle placement and alcohol spread. January, 1993, to July, 1996, twenty-one bilateral splanchnic nerve blocks were performed through the posterior access. Forty-eight hours after alcoholization, 14 patients (66%) had complete pain regression; 52% of the patients needed no analgesics for 6 to 54 days and only 9 patients (42%) needed another low opioid therapy. Complications included hypotension and diarrhea in all cases. One had a cardiac arrest and died 8 days after the procedure. There were no other complications. The whole procedure usually lasted 60 min (range: 45 to 90 min). Splanchnic nerve neurolysis is a useful treatment in the patients with severe chronic abdominal pain. It is used as a second line treatment when large lesions change celiac anatomy and complicate the percutaneous block of the celiac plexus.
CT引导下内脏神经溶解阻滞是一种缓解腹部癌痛的技术；其目的是通过酒精使腹膜后间隙的敏感结构发生神经溶解中断。CT能提供准确的解剖细节以及进针位置和酒精扩散路径。1993年1月至1996年7月，通过后路进行了21例双侧内脏神经阻滞。酒精注射后48小时，14例患者（66%）疼痛完全缓解；52%的患者在6至54天内无需使用镇痛药，只有9例患者（42%）需要再次进行低剂量阿片类药物治疗。并发症包括所有病例均出现低血压和腹泻。1例患者心脏骤停，术后8天死亡。无其他并发症。整个手术通常持续60分钟（范围：45至90分钟）。内脏神经溶解术对严重慢性腹痛患者是一种有效的治疗方法。当大的病变改变腹腔解剖结构并使经皮腹腔神经丛阻滞复杂化时，它可作为二线治疗方法。
