Evaluation of Trans-aortic Oblique Fluoroscopic Tunnel Vision Approach of Celiac Plexus Block after Failure of the Classic Approach

The conventional techniques of neurolytic celiac plexus block (NCBP) sometimes cannot be used in patients who have organomegaly, or not be able to tolerate the prone position necessary to place the needles also anatomic anomalies may hinder obliquely placed needles from effectively reaching the target area. Complications such as organ puncture cannot be avoided with conventional techniques. The purpose of this study was to evaluate the safety and efficacy of approach of celiac plexus alcohol block. Fifty patients with advanced upper abdominal cancer were included in the study. A single needle percutaneous transaortic oblique fluoroscopic tunnel vision view of the needle at the level of middle L1 vertebra was applied. Visual analog score, daily morphine consumption, duration of the procedure, adverse effects, and Quality of Life Questionnaire-C30 were recorded. No failure was recorded with expected adverse effects. The mean visual analog score, daily morphine consumption, and Quality of Life Questionnaire-C30 score were significantly decreased. The oblique fluoroscopic tunnel vision approach of NCPB for upper abdominal cancer pain is proved to be safe and reliable.