Endoscopic ultrasound-guided celiac plexus neurolysis using a reverse phase polymer.
OBJECTIVE
To assess the feasibility of endoscopic ultrasound (EUS)-guided celiac plexus neurolysis (CPN) using a poloxamer.


METHODS
In this prospective evaluation, six Yorkshire pigs underwent EUS-guided CPN. Three received an injection of 10 mL of 0.25% Lidocaine plus methylene blue (group 1) and three received an injection of 10 mL of 0.25% Lidocaine plus blue colored poloxamer (PS137-25) (group 2). Necropsy was performed immediately after the animals were sacrificed. The abdominal and pelvic cavities were examined for the presence of methylene blue and the blue colored poloxamer.


RESULTS
EUS-guided CPN was successfully performed in all 6 pigs without immediate complication. Methylene blue was identified throughout the peritoneal and retroperitoneal cavity in group 1. The blue colored poloxamer was found in the retroperitoneal cavity immediately adjacent to the aorta, in the exact location of the celiac plexus in group 2.


CONCLUSIONS
EUS-guided CPN using a reverse phase polymer in a non-survival porcine model was technically feasible. The presence of a poloxamer gel at the site of the celiac plexus at necropsy indicates a precise delivery of the neurolytic agent.
Gastroenterology Division, Brigham and Women's Hospital, Boston, MA 02115, United States.
Keith L
KL
Obstein
Fernanda P
FP
Martins
Gloria
G
Fernández-Esparrach
Christopher C
CC
Thompson
D000779:Anesthetics, Local; D000818:Animals; D002447:Celiac Plexus / Q000000981:diagnostic imaging* / Q000503:physiopathology; D019160:Endosonography; D005240:Feasibility Studies; D007267:Injections; D008012:Lidocaine; D023421:Models, Animal; D009407:Nerve Block / Q000379:methods*; D011108:Polymers; D011446:Prospective Studies; D013552:Swine
D000779:Anesthetics, Local; D011108:Polymers; D008012:Lidocaine