| Central vs. bilateral endoscopic ultrasound-guided celiac plexus block or neurolysis: a comparative study of short-term effectiveness. | |
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MedLine Citation:
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PMID: 19174816 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: Endoscopic ultrasound (EUS)-guided celiac plexus block/neurolysis (CPB/N) can be performed by injecting at the base (central) or on either side (bilateral) of the celiac axis. Central CPB/N is easier and possibly safer. Bilateral CPB/N is more difficult but may be more effective as it reaches more ganglia. The aim of this study was to compare the short-term safety and efficacy of central and bilateral CPB/N. METHODS: Consecutive patients referred for CPB/N to a quaternary EUS center were eligible for this study. Central CPB/N was used in the first half of the study period and bilateral CPB/N in the last half. The primary outcome was the percent reduction in visual analog pain scores at day 7. RESULTS: A total of 184 patients were eligible. Out of them, 24 (13%) were excluded for incomplete data. A total of 160 were left (71 central, 89 bilateral). The groups were similar for all cogent variables. Bilateral CPB/N was more effective than central CPB/N (mean percent pain reduction 70.4% (61.0-80.0) vs. 45.9% (32.7-57.4); P=0.0016). The only predictor of a >50% pain reduction was bilateral CPB/N (odds ratio 3.55, 1.72-7.34). Only one complication was noted: self-limited bleeding because of laceration of the adrenal artery following bilateral celiac plexus (CP) block in an anticoagulated patient. CONCLUSIONS: (i) Bilateral CPB/N is more effective than central CPB/N; (ii) bilateral CPB/N is safe, but on rare occasions can cause trauma to the left adrenal artery; it should therefore be avoided in patients with a bleeding diathesis. |
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Authors:
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Anand V Sahai; Valéry Lemelin; Eric Lam; Sarto C Paquin |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article Date: 2009-01-06 |
Journal Detail:
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Title: The American journal of gastroenterology Volume: 104 ISSN: 1572-0241 ISO Abbreviation: Am. J. Gastroenterol. Publication Date: 2009 Feb |
Date Detail:
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Created Date: 2009-02-04 Completed Date: 2009-03-03 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0421030 Medline TA: Am J Gastroenterol Country: United States |
Other Details:
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Languages: eng Pagination: 326-9 Citation Subset: IM |
Affiliation:
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Gastroenterology, CHUM, Montreal, Quebec, Canada. anand.sahai@sympatico.ca |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Abdominal Pain
/
etiology,
therapy* Anesthetics / administration & dosage* Autonomic Nerve Block / methods* Celiac Plexus* Endosonography* Ethanol / administration & dosage Female Follow-Up Studies Humans Male Middle Aged Pancreatitis, Chronic / complications Solvents / administration & dosage* Time Factors Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Anesthetics; 0/Solvents; 64-17-5/Ethanol |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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