Abstract
The purpose of this article is to familiarize the anaesthetist with the basic anatomy of the coeliac plexus; the techniques used to perform the procedure, its indications, complications and results in the management of chronic abdominal pain syndromes. Radiological, surgical and anaesthetic literature from the beginning of the century were reviewed. The main indication for neurolytic coeliac plexus block is intractable pain secondary to carcinoma of the pancreas or stomach. There appear to be theoretical advantages to techniques that result in spread of solution anterior to the aorta, such as the trans-aortic approach. These have not yet been demonstrated in any studies with large numbers of patients.
Résumé
Le propos de cet article est de familiariser l’anesthésiste à l’anatomie de base du plexus coeliaque, aux techniques de réalisation du bloc, ses indications, ses complications et ses résultats dans la prise en charge des syndromes de douleurs abdominales chroniques. On revoit la littérature radiologique, chirurgicale et anesthésique à partir du début du siècle. La principale indication du bloc neurolytique du plexus coeliaque est la douleur refractaire due au carcinome du pancréas ou de l’estomac. Il y aurait des avantages théoriques aux techniques qui consistent à diffuser la solution en avant de l’aorte, comme l’approche trans- aortique. Aucune étude comprenant un grand nombre de patients n’a encore démontré ces avantages.
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Fugère, F., Lewis, G. Coeliac plexus block for chronic pain syndromes. Can J Anaesth 40, 954–963 (1993). https://doi.org/10.1007/BF03010099
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DOI: https://doi.org/10.1007/BF03010099