Monitoring of celiac plexus block in chronic pancreatitis.

Pain
J MyhreH Worning

Abstract

Pharmacological, percutaneous celiac plexus blockade is often inefficient in the treatment of pain in chronic pancreatitis. Lack of efficiency could be due to incomplete denervation of the plexus; however, a method for measuring the completeness of celiac plexus blockade is not yet available. We have, therefore, monitored the physiological completeness of pharmacological percutaneous celiac blockade with 40 ml 25% ethanol by measuring the effect of posture on heart rate, blood pressure, hepato-splanchnic vascular resistance, and pancreatic hormone concentrations before and after celiac plexus block in 6 patients with chronic pancreatitis. Blood pressure decreased and heart rate increased after the block (P less than 0.025), whereas no significant change was found in hepato-splanchnic vascular resistance nor in the change of these parameters during transition from the supine to standing position. Pancreatic hormones (C-peptide, free insulin, glucagon, pancreatic polypeptide and somatostatin) did not change in response to standing, either before or after the block. The cardiovascular variables were normalized the day after the block, and all the patients were in their habitual state regarding pain after 1 week. In conclusion, pan...Continue Reading

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Citations

Mar 18, 2010·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·Marios LoukasAnna Zurada
Nov 24, 2004·Gastrointestinal Endoscopy Clinics of North America·Jason B Klapman, Kenneth J Chang
Aug 5, 2000·The American Journal of Gastroenterology·T J McGarrityS J McGarrity
Jan 1, 1996·Scandinavian Journal of Gastroenterology. Supplement·N T Pedersen, H Worning

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