[The transintervertebral disc approach for educational practice of the neurolytic celiac plexus block].
BACKGROUND
The transintervertebral disc approach was proposed recently for percutaneous neurolytic celiac plexus block (NCPB). Its superior simplicity, reliability, as well as safety potentially overcome the technical hurdles of NCPB that may interfere with the practical use of this validated analgesic intervention for abdominal cancer pain. The present study was conducted to evaluate the effectiveness of the use of this approach in a resident education program for NCPB.


METHODS
The clinical results of NCPBs conducted from January 2001 to September 2002 were examined comparing that performed by institutional residents with that by specialized physicians authorized by the Japanese Society of Pain Clinicians. The transintervertebral disc approach was used in all cases. Each resident completed NCPB under close supervision of the specialists.


RESULTS
Twenty-four patients received NCPB during the study period. Seven residents randomly completed 12 procedures and 4 specialists did others. The duration of fluoroscopy to complete the procedure was 256+/-109 sec in the resident group and 392+/-194 sec in the specialist group (ns). Significant pain reduction was obtained immediately after NCPB in all patients without any intergroup difference. No critical complication was observed in each group.


CONCLUSIONS
The transintervertebral disc approach can be used effectively and safely in educational practice of NCPB for less-trained physicians.
Toraiwa
Satoshi
S
Department of Palliative Medicine, Tohoku University Hospital, Sendai 980-8574.
Ohara
Takeshi
T
Yamanaka
Hiroyuki
H
Yamamoto
Yoko
Y
Takahashi
Masahiko
M
D000008:Abdominal Neoplasms / Q000150:complications; D000776:Anesthesiology / Q000193:education*; D002447:Celiac Plexus; D002983:Clinical Competence; D004503:Education, Medical, Graduate / Q000379:methods*; D006801:Humans; D007396:Internship and Residency; D007403:Intervertebral Disc; D009407:Nerve Block / Q000379:methods*; D010146:Pain / Q000209:etiology; D018710:Pain Clinics; D059408:Pain Management; D010166:Palliative Care / Q000379:methods; D013038:Specialization