Completed

NCT Number: NCT02692456

Effect of Patient Position on Computerized Tomography Guided Celiac Trunk Neurolysis

Computerized tomography-guided Celiac plexus neurolysis has become a popular technique. As, it has Cross-section imaging system to avoids anatomic structures injury, it has high density resolution that clearly display the retro-peritoneal anatomic structures ,it allow an optimal puncture site selection and measured the angle and depth of the needle insertion accurately with display the range of the neurolytic agent diffusion

Completed

Looking for future studies?

Notify Me

Key information

Conditions

Upper Abdominal Malignancy

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Mansoura University Cancer Institute

Al Mansurah, DK, 050, Egypt

About this study

The aim of this study was to evaluate analgesic efficacy of a computerized tomography guided left lateral antero-crural approach near the origin of celiac trunk with patients position on their right side immediately after the procedure using a single needle injection technique for upper abdominal malignancy compared with the classic 2 needle posterior antero-crural injection technique and possible complications.

All patients will take thin computerized tomography section in the axial plane to detect the site of celiac plexus and coronal plane for correct site for needle placement.

Computerized tomography slices thickness will be from 3 mm at 5mm interval through all the abdominal and lower thoracic area. The celiac and superior mesenteric arteries will be identified after contrast injection.

When an ideal needle position and tip were confirmed, the stylet was removed and aspiration was performed to ensure that there was no blood is withdrawn.

A volume of 3 ml of lidocaine mixed with contrast was injected to confirm the position, after injection another cut has been taken to show the spread of contrast freely in the retro-peritoneal space around the celiac plexus and the aorta. After confirmation, that contrast was injected to surround the artery and make sure that there was no dorsal spread to avoid injury to somatic nerves. Also to make sure that there was no spread to the renal pelvis , injection of phenol 10% mixed with contrast through needle

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Patients with gastric carcinoma
Patients with hepato-biliary-pancreatic cancer
Patients with colonic malignancy
Patients with peritoneal metastasis
Patients with extensive hepatic metastasis
Patients having intractable pain to opioids and other analgesics.
Patients experienced adverse effects to opioids or other analgesics.
Patients experienced improved intractable pain after diagnostic celiac plexus block

Exclusion criteria

Patient's refusal
Patients with bleeding tendency
Patients with coagulopathy
Patients who were benefited from oral analgesics with no serious side effects
Patients with significant cardiac diseases
Patients with organ failure
Patients with distant vertebral metastasis
Evidence of local infection at the puncture site
Patients who did not experience improved pain after receiving a diagnostic celiac plexus block

Treatment and study plan

Double needle celiac neurolysis (DNCN)

Device

CT guided celiac neurolysis will be performed using 2 needles inserted on each sides of aorta where patient was positioned in prone position

Single needle celiac neurolysis (SNCN)

Device

CT guided celiac neurolysis will be performed through advancing a single needle to justfront of the aorta near the origin of celiac trunk where patient placed in lateral position

Primary outcomes

Failure rate of patients positioning

Time frame: For 5 min before needle insertion

Positioning failure means failure to put patient in prone or lateral position

Secondary outcomes

Time to achieve analgesia

Time frame: for one hour after performing the procedure

Time to achieve pain score less than 3
Failure of block

Time frame: For 1 week after performing the procedure

Failure of block is defined as patient having pain visual analogue scale greater than 3

Sponsors and collaborators

Lead sponsor

Mansoura University

Other

Registry information

Official study title

Efficacy of Patient Position After Computerized Tomography Guided Antero-crural Celiac Trunk Neurolysis on Upper Abdominal Malignancy Pain

Important dates

Study start: 2015
Primary completion: 2015
Study completion: 2015
First posted: Feb 26, 2016
Registry last updated: Feb 26, 2016

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.