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Article: Neurolytic celiac plexus block for visceral abdominal malignancy: is prior diagnostic block warranted?

TitleNeurolytic celiac plexus block for visceral abdominal malignancy: is prior diagnostic block warranted?
Authors
Issue Date2002
PublisherAustralian Society of Anaesthetists. The Journal's web site is located at http://www.aaic.net.au
Citation
Anaesthesia and Intensive Care, 2002, v. 30 n. 4, p. 442-448 How to Cite?
AbstractNeurolytic celiac plexus block is a recognised treatment for visceral abdominal pain due to malignancy. The need for a diagnostic celiac plexus block prior to neurolytic blockade is of questionable value, as it may not predict a positive response and may incorrectly predict a lack of response. Our objective is to evaluate the efficacy of diagnostic celiac plexus block. The records of 59 patients treated with celiac plexus block during 1994-2000 were retrospectively reviewed. Diagnostic block was performed on 32 patients prior to the decision for subsequent neurolytic block (Group 1). Another 27 patients were directly treated with a neurolytic celiac plexus block (Group 2). Response of Group 1 to diagnostic and neurolytic blocks was compared. Data from Group 2 was used to project the response of Group 1 should those patients with negative response to diagnostic block proceeded to neurolytic block. A two-by-two table was then constructed. The diagnostic celiac plexus block predicted a positive response with a sensitivity of 93% and a specificity of 37%. The positive predictive value was 85% and the negative predictive value was 58%. The estimated 'number needed to test' before a 'true' nonrespondent to lytic block to be detected was 16.7. Therefore, a positive response to diagnostic block correlates positively with neurolytic celiac plexus block for abdominal visceral pain due to malignancy. However, diagnostic block is a poor predictor when the response is negative. Hence, its clinical role is questionable and may not be warranted for patients with terminal malignancy.
Persistent Identifierhttp://hdl.handle.net/10722/67274
ISSN
2015 Impact Factor: 1.283
2015 SCImago Journal Rankings: 0.488
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorYuen, TSTen_HK
dc.contributor.authorNg, KFJen_HK
dc.contributor.authorTsui, SLen_HK
dc.date.accessioned2010-09-06T05:53:31Z-
dc.date.available2010-09-06T05:53:31Z-
dc.date.issued2002en_HK
dc.identifier.citationAnaesthesia and Intensive Care, 2002, v. 30 n. 4, p. 442-448en_HK
dc.identifier.issn0310-057Xen_HK
dc.identifier.urihttp://hdl.handle.net/10722/67274-
dc.description.abstractNeurolytic celiac plexus block is a recognised treatment for visceral abdominal pain due to malignancy. The need for a diagnostic celiac plexus block prior to neurolytic blockade is of questionable value, as it may not predict a positive response and may incorrectly predict a lack of response. Our objective is to evaluate the efficacy of diagnostic celiac plexus block. The records of 59 patients treated with celiac plexus block during 1994-2000 were retrospectively reviewed. Diagnostic block was performed on 32 patients prior to the decision for subsequent neurolytic block (Group 1). Another 27 patients were directly treated with a neurolytic celiac plexus block (Group 2). Response of Group 1 to diagnostic and neurolytic blocks was compared. Data from Group 2 was used to project the response of Group 1 should those patients with negative response to diagnostic block proceeded to neurolytic block. A two-by-two table was then constructed. The diagnostic celiac plexus block predicted a positive response with a sensitivity of 93% and a specificity of 37%. The positive predictive value was 85% and the negative predictive value was 58%. The estimated 'number needed to test' before a 'true' nonrespondent to lytic block to be detected was 16.7. Therefore, a positive response to diagnostic block correlates positively with neurolytic celiac plexus block for abdominal visceral pain due to malignancy. However, diagnostic block is a poor predictor when the response is negative. Hence, its clinical role is questionable and may not be warranted for patients with terminal malignancy.en_HK
dc.languageengen_HK
dc.publisherAustralian Society of Anaesthetists. The Journal's web site is located at http://www.aaic.net.auen_HK
dc.relation.ispartofAnaesthesia and Intensive Careen_HK
dc.subject.meshAbdominal Neoplasms - complicationsen_HK
dc.subject.meshAnesthetics, Local - administration and dosage - diagnostic useen_HK
dc.subject.meshAutonomic Nerve Blocken_HK
dc.subject.meshCeliac Plexusen_HK
dc.subject.meshPain, Intractable - diagnosis - etiology - therapyen_HK
dc.titleNeurolytic celiac plexus block for visceral abdominal malignancy: is prior diagnostic block warranted?en_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0310-057X&volume=30&spage=442&epage=448&date=2002&atitle=Neurolytic+celiac+plexus+block+for+visceral+abdominal+malignancy:+is+prior+diagnostic+block+warranted?en_HK
dc.identifier.emailNg, KFJ: jkfng@hku.hken_HK
dc.identifier.emailTsui, SL: sltsui@hkucc.hku.hk-
dc.identifier.authorityNg, KFJ=rp00544en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.pmid12180582-
dc.identifier.scopuseid_2-s2.0-0036022986en_HK
dc.identifier.hkuros80450en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0036022986&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume30en_HK
dc.identifier.issue4en_HK
dc.identifier.spage442en_HK
dc.identifier.epage448en_HK
dc.identifier.isiWOS:000177351800007-
dc.publisher.placeAustraliaen_HK

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