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Article: Neurolytic celiac plexus block for visceral abdominal malignancy: is prior diagnostic block warranted?
Title | Neurolytic celiac plexus block for visceral abdominal malignancy: is prior diagnostic block warranted? |
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Authors | |
Keywords | Cancer: Celiac plexus block Diagnostic block Neurolytic block Pain Predictive value |
Issue Date | 2002 |
Publisher | Australian 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? |
Abstract | Neurolytic 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 Identifier | http://hdl.handle.net/10722/67274 |
ISSN | 2023 Impact Factor: 1.1 2023 SCImago Journal Rankings: 0.534 |
ISI Accession Number ID | |
References |
DC Field | Value | Language |
---|---|---|
dc.contributor.author | Yuen, TST | en_HK |
dc.contributor.author | Ng, KFJ | en_HK |
dc.contributor.author | Tsui, SL | en_HK |
dc.date.accessioned | 2010-09-06T05:53:31Z | - |
dc.date.available | 2010-09-06T05:53:31Z | - |
dc.date.issued | 2002 | en_HK |
dc.identifier.citation | Anaesthesia and Intensive Care, 2002, v. 30 n. 4, p. 442-448 | en_HK |
dc.identifier.issn | 0310-057X | en_HK |
dc.identifier.uri | http://hdl.handle.net/10722/67274 | - |
dc.description.abstract | Neurolytic 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.language | eng | en_HK |
dc.publisher | Australian Society of Anaesthetists. The Journal's web site is located at http://www.aaic.net.au | en_HK |
dc.relation.ispartof | Anaesthesia and Intensive Care | en_HK |
dc.subject | Cancer: Celiac plexus block | - |
dc.subject | Diagnostic block | - |
dc.subject | Neurolytic block | - |
dc.subject | Pain | - |
dc.subject | Predictive value | - |
dc.subject.mesh | Abdominal Neoplasms - complications | en_HK |
dc.subject.mesh | Anesthetics, Local - administration and dosage - diagnostic use | en_HK |
dc.subject.mesh | Autonomic Nerve Block | en_HK |
dc.subject.mesh | Celiac Plexus | en_HK |
dc.subject.mesh | Pain, Intractable - diagnosis - etiology - therapy | en_HK |
dc.title | Neurolytic celiac plexus block for visceral abdominal malignancy: is prior diagnostic block warranted? | en_HK |
dc.type | Article | en_HK |
dc.identifier.openurl | http://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.email | Ng, KFJ: jkfng@hku.hk | en_HK |
dc.identifier.email | Tsui, SL: sltsui@hkucc.hku.hk | - |
dc.identifier.authority | Ng, KFJ=rp00544 | en_HK |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.1177/0310057X0203000407 | - |
dc.identifier.pmid | 12180582 | - |
dc.identifier.scopus | eid_2-s2.0-0036022986 | en_HK |
dc.identifier.hkuros | 80450 | en_HK |
dc.relation.references | http://www.scopus.com/mlt/select.url?eid=2-s2.0-0036022986&selection=ref&src=s&origin=recordpage | en_HK |
dc.identifier.volume | 30 | en_HK |
dc.identifier.issue | 4 | en_HK |
dc.identifier.spage | 442 | en_HK |
dc.identifier.epage | 448 | en_HK |
dc.identifier.isi | WOS:000177351800007 | - |
dc.publisher.place | Australia | en_HK |
dc.identifier.issnl | 0310-057X | - |