title: [Ganglion block. Celiac plexus neurolysis].
abstract: BACKGROUND
  Pain originating from the organs of the upper abdomen, especially in patients suffering from inoperable carcinoma of the pancreas or advanced inflammatory conditions, is difficult to treat in a significant number of patients.
  Computed tomography (CT) guided neurolysis is the most commonly used technique for neurolysis of the celiac plexus. Ethanol is used to destroy the nociceptive fibers passing through the plexus and provides an effective means of diminishing pain arising from the upper abdomen.
  
  
  METHODS
  Using either an anterior or posterior approach, a 22 G Chiba needle is advanced to the antecrural space and neurolysis is achieved by injecting a volume of 20-50 ml of ethanol together with a local anesthetic and contrast medium.
  
  
  METHODS
  In up to 80% of patients suffering from tumors of the upper abdomen, CT-guided celiac plexus neurolysis diminishes pain or allows a reduction of analgesic medication; however, in some patients the effect may only be temporary necessitating a second intervention. In inflammatory conditions, celiac neurolysis is often less effective in reducing abdominal pain.
  
  
  CONCLUSIONS
  The CT-guided procedure for neurolysis of the celiac plexus is safe and effective in diminishing pain especially in patients suffering from tumors of the upper abdomen. The procedure can be repeated if the effect is only temporary.
authors.affiliation: Klinik für diagnostische und interventionelle Radiologie und Nuklearmedizin, Klinikum Esslingen gGmbH, Hirschlandstr. 97, 73730, Esslingen, Deutschland, S.Kraemer@klinikum-esslingen.de.
authors.forename: S C
authors.initials: SC
authors.lastname: Krämer
authors.forename: R
authors.initials: R
authors.lastname: Meier
authors.forename: H
authors.initials: H
authors.lastname: Seifarth
mesh_terms: D015746:Abdominal Pain / Q000000981:diagnostic imaging / Q000188:drug therapy*; D000700:Analgesics / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002447:Celiac Plexus / Q000000981:diagnostic imaging / Q000187:drug effects*; D004359:Drug Therapy, Combination / Q000379:methods; D000431:Ethanol / Q000008:administration & dosage*; D006801:Humans; D007267:Injections / Q000379:methods; D009407:Nerve Block / Q000379:methods*; D015641:Radiography, Interventional / Q000379:methods*; D012597:Sclerosing Solutions / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D000700:Analgesics; D000779:Anesthetics, Local; D012597:Sclerosing Solutions; D000431:Ethanol