Treatment of complications of celiac plexus block

By | April 2, 2012

Treatment of complications of celiac plexus block, celiac plexus block after surgery, transient diarrhea and hypotension after sympathetic block for the common clinical manifestations, incidence rates were 38% and 44%. For the dense plexus of visceral afferent nerve plexus network of nerves and the sympathetic afferent fibers visceral efferent. Therefore, the absolute alcohol celiac plexus damage, not only weakened abdominal neural transmission of pain (pancreas, liver, stomach, kidney, small intestine and proximal colon), and will result in less sympathetic efferent activity. Clinically, sympathetic blockade, the relative increase in parasympathetic activity, the parasympathetic nervous excitement of clinically manifested as diarrhea and hypotension.
The authors reported a case, the 9% of patients self-limiting diarrhea lasting less than 48 hours, 1 patient symptoms persist for up to 7 days. Nearly 20% of the patients showed transient hypotension, blood pressure, a decrease of 10% -15%. All cases of intravenous infusion for low blood pressure effectively, none of the patients had persistent hypotension.
Celiac plexus block treatment of complications, major complications occurred in the percutaneous treatment of celiac plexus block way, more rare (1% of cases) of complications, including lower limb weakness and sensory dysfunction, Yang desolate, bladder control, kidney rupture, stomach paralysis and prolonged diarrhea. CPN's the most common neurological complications occurred in the path after percutaneous injection. Appears to be due to spinal cord ischemia, or direct injection of the subarachnoid or somatic nerves. However, the paralysis has also been reported in surgery of the CPN. Spinal cord ischemia may be due to AdamkleWlCZ twin arterial thrombosis or recover from illness caused. Adamkiewicz artery in the left side of Ts and L4 vertebrae, the spinal cord supply the first 2 / 3 of the blood flow. CPN can be reduced before the path of neurological complications, the puncture needle does not cross the anterior region or somatic nerves.
1% of the cases (including post-path), including pneumothorax, breast health chest, shoulders, or chest pain, Nick inverse or hematuria (with puncture to the chest muscle and kidney related). Rarely include retroperitoneal hemorrhage and vascular injury. No reported deaths occurred.
EUS-CPB/CPN tolerated treatment for safety, can be carried out in the clinic. Operating time about 10 minutes. Minor complications included transient diarrhea (4% – 15%), transient orthostatic hypotension (1%), transient abdominal pain (9%). Major complications (2.5%) of retroperitoneal bleeding, swollen membrane weeks edition. Blood pressure should be monitored after 2 hours. Of diarrhea and low blood pressure for appropriate action.
Treatment of complications of celiac plexus block, by using of EUS-CPN (EUS: PENT AX-FG-36UX) treated 20 patients with upper abdominal cancer pain patients, including 16 cases of pancreatic cancer, 2 cases of gallbladder cancer, gastric cancer , 1 case of liver carcinoma in 1 case. Significant pain relief in 17 cases. Maximum efficacy of 16 weeks, part of the CPN early postoperative pancreatic cancer even without use of narcotic drugs, 18 cases were combined to reduce the amount of anesthetic. Complications include diarrhea, hypotension, abdominal pain, short-term increase, 1 patient occurred in the splenic artery embolism. None of the patients developed infections.

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