복강신경총 차단시의 조영제 확산

Abstract

Celiac plexus block is performed to relieve intractable upper abdominal cancer pain. Gener- ally, celiac plexus blocks have heen performed under control of X-ray fluoroscopy to determine the position of the needle tip and the spread of contrast media. During the period from March 1992 to February l994, we have performed 21 cases of neurolytic celiac plexus block to alleviate pain of intra-abdominal malignancy. We retroapec- tively evaluated the location of the needle tip and the spread of contrast media. P-A views of simple abdomen demonstrated the locations of the needle tip: 66.7% of the left needle tips were in upper 3/l of Ll (6 cases) and T12-Li interspace (8 cases), 50% of the right needle tips were in upper 1/3 of L, (6 cases) and T,-L1 interspace (4 cases). Contrast media from the right needle spread upward to middle 1/3 of T10 (5 cases) and middle 1/3 of T1 (5 cases), downward to middle 1/3 of L, (6 cases) and lower l/3 of L1 (3 cases). Contrast media from the left needle were spread upward to middle 1/3 of T10 (5 cases) and evenly to other spaces, downward to middle l/3 of L, (4 cases) and L,-L interspace (6 cases). We analyze the spread of contrast media according to distance from needle tip by authors score system.Contrast media of right needle spread upward 6.1 and downward 3.4, that of left needle spread upward 6.5 and downward 3.7.