The effect of celiac plexus block in critically ill patients intolerant of enteral nutrition: a randomized, placebo-controlled study.
Anesth Analg
; 110(4): 1071-5, 2010 Apr 01.
Article
in En
| MEDLINE
| ID: mdl-20103540
ABSTRACT
BACKGROUND:
In this study, we evaluated the efficacy of celiac plexus block for the treatment of feeding intolerance in critically ill patients.METHODS:
Nineteen mechanically ventilated medical patients intolerant of enteral nutrition and receiving metoclopramide underwent bilateral celiac plexus block. The anterior procedure was accomplished under sonographic guidance with the injection of either 25 mL bupivacaine 0.25% (celiac group, n = 10) or saline (control group, n = 9) bilaterally. Gastric emptying was assessed by the acetaminophen absorption method. After the block, nasogastric feeding was commenced, and nasogastric aspirates were collected once every 24 hours. Successful feeding was defined as 24-hourly gastric residual volume <250 mL with a feeding rate > or = 40 mL/h.RESULTS:
Demographic data were similar for the 2 groups. The area under the plasma paracetamol absorption curve (383.8 +/- 248.1 mg . min . L(-1)) and the peak plasma paracetamol concentration (C(max); 3.28 +/- 2.15 mg/L) in the celiac group were significantly lower than the area under the curve value (1233.5 +/- 771.2) and C(max) value (10.14 +/- 6.04) in controls (P < 0.001 for all). After treatment, celiac plexus block reduced the mean gastric residual volume (celiac group 430 +/- 32 mL to 205 +/- 30 mL, P < 0.001; control group 450 +/- 33 mL to 461 +/- 19 mL, P > 0.05) and improved the proportion of patients with successful feeding (celiac block 80% vs controls 0%, P < 0.001).CONCLUSION:
In critical illness, celiac plexus block is effective for treating feeding intolerance when IV drug therapy has failed to improve gastrointestinal dysfunction.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Celiac Plexus
/
Critical Illness
/
Enteral Nutrition
/
Nerve Block
Type of study:
Clinical_trials
/
Guideline
/
Prognostic_studies
Limits:
Adolescent
/
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Anesth Analg
Year:
2010
Document type:
Article
Affiliation country:
Turkey