Ultrasound-guided percutaneous celiac plexus neurolysis using the anterior transgastric approach and continuous flow apneic ventilation: case report

• Main Authors: Rodrigo Gobbo Garcia, Alexandre Maurano, Marcio Martines dos Santos, Carlos Leite de Macedo Filho, Antonio Luiz Vasconcellos Macedo, Miguel José Francisco Neto, Marcelo Buarque Gusmão Funari
• Format: Article
• Language: English
• Published: Instituto Israelita de Ensino e Pesquisa Albert Einstein 2009-09-01
• Series: Einstein (São Paulo)
• Subjects: Celiac plexus; Alcoholism; Ultrasonography; doppler; color; Anesthesia; interventional; Case reports
• Online Access: http://apps.einstein.br/revista/arquivos/PDF/736-Einstein%20v7n3p361-4.pdf

Percutaneous celiac plexus neurolysis is an effective method to relieve pain in advanced abdominal cancer, especially in patients with pancreatic carcinoma. It was performed a percutaneous celiac plexus neurolysis, using the anterior transgastric route, under general anesthesia and apneic oxygenation in a patient with an advanced pancreatic adenocarcinoma and chronic abdominal pain refractory to clinical treatment. A color Doppler ultrasound detectable flow at the tip of a Turner-22G needle through continuous injection of saline solution was produced. This technique showed the exact position of the needle dynamically during its progression. Then, 30 ml of ethanol was infused into the preaortic space. The procedure took around eight minutes, and the patient expressed significant pain relief and decrease in his narcotic analgesics requirements.