Upper Abdominal Malignancy Clinical Trial
Official title:
Efficacy of Patient Position After Computerized Tomography Guided Antero-crural Celiac Trunk Neurolysis on Upper Abdominal Malignancy Pain
Computerized tomography-guided Celiac plexus neurolysis has become a popular technique. As, it has Cross-section imaging system to avoids anatomic structures injury, it has high density resolution that clearly display the retro-peritoneal anatomic structures ,it allow an optimal puncture site selection and measured the angle and depth of the needle insertion accurately with display the range of the neurolytic agent diffusion
The aim of this study was to evaluate analgesic efficacy of a computerized tomography guided
left lateral antero-crural approach near the origin of celiac trunk with patients position
on their right side immediately after the procedure using a single needle injection
technique for upper abdominal malignancy compared with the classic 2 needle posterior
antero-crural injection technique and possible complications.
All patients will take thin computerized tomography section in the axial plane to detect the
site of celiac plexus and coronal plane for correct site for needle placement.
Computerized tomography slices thickness will be from 3 mm at 5mm interval through all the
abdominal and lower thoracic area. The celiac and superior mesenteric arteries will be
identified after contrast injection.
When an ideal needle position and tip were confirmed, the stylet was removed and aspiration
was performed to ensure that there was no blood is withdrawn.
A volume of 3 ml of lidocaine mixed with contrast was injected to confirm the position,
after injection another cut has been taken to show the spread of contrast freely in the
retro-peritoneal space around the celiac plexus and the aorta. After confirmation, that
contrast was injected to surround the artery and make sure that there was no dorsal spread
to avoid injury to somatic nerves. Also to make sure that there was no spread to the renal
pelvis , injection of phenol 10% mixed with contrast through needle
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Supportive Care