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Computed Tomography (CT) Simulated Fluoroscopy-Guided Transdiscal Approach in Transcrural Celiac Plexus Block
- Source :
- The Korean Journal of Pain
- Publication Year :
- 2013
- Publisher :
- The Korean Pain Society, 2013.
-
Abstract
- Conventional transcrural CPB via the "walking off" the vertebra technique may injure vital organs while attempting to proximally spread injectate around the celiac plexus. Therefore, we attempted the CT-simulated fluoroscopy-guided transdiscal approach to carry out transcrural CPB in a safer manner, spreading the injectate more completely and closely within the celiac plexus area. A 54-year-old male patient with pancreatic cancer suffered from severe epigastric pain. The conventional transcrural approach was simulated, but the needle pathway was impeded by the kidney on the right side and by the aorta on the left side. After simulating the transdiscal pathway through the T11-12 intervertebral disc, we predetermined the optimal insertion point (3.6 cm from the midline), insertion angle (18 degrees), and advancement plane, as well as the proper depth. With the transdiscal approach, we successfully performed transcrural CPB within a narrow angle, and the bilateral approach was not necessary as we were able to achieve the bilateral spread of the injectate with the single approach.
- Subjects :
- Aorta
medicine.medical_specialty
medicine.diagnostic_test
business.industry
transdiscal approach
Brief Report
Celiac plexus
Computed tomography
Intervertebral disc
Epigastric pain
Celiac plexus block
Vertebra
Surgery
Anesthesiology and Pain Medicine
medicine.anatomical_structure
celiac plexus block
medicine.artery
Medicine
Fluoroscopy
Radiology
CT simulated fluoroscopy-guided
business
transcrural approach
Subjects
Details
- Language :
- English
- ISSN :
- 20930569 and 20059159
- Volume :
- 26
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- The Korean Journal of Pain
- Accession number :
- edsair.doi.dedup.....19a6183b20c06527cdf4ca3d623de1a4