Surya .R - Associate Professor, Department of Anaesthesiology, Saveetha Medical college and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Thandalam, Chennai, Tamilnadu, India
Priya .H - Assistant Professor, Department of Anaesthesiology, Meenakshi Medical College, Hospital and Research Institiute, Meenakshi Academy of Higher Education and Research, Kanchipuram, Tamilnadu, India
B.M. Sathesh Kumar - Assistant Professor, Department of Anaesthesiology, Saveetha Medical college and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Thandalam, Chennai, Tamilnadu, India
Ameerunnisha Begum - Post Graduate Resident, Department of Anaesthesiology, Saveetha Medical college and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Thandalam, Chennai, Tamilnadu, India
Yachendra V.S.G - Associate Professor, Department of Anaesthesiology, Saveetha Medical college and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Thandalam, Chennai, Tamilnadu, India
Lakshmi .R - Professor and Head, Department of Anaesthesiology, Saveetha Medical college and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Thandalam, Chennai, Tamilnadu, India

Background: General or Regional anaesthesia are the most common anaesthetic techniques practiced for open palliative feeding jejunostomy (PFJ) for advanced esophageal cancer. However, it is not devoid of technique specific complications accounting to perioperative morbidity and mortality. In this study, a combination of ultrasound guided bilateral Subcostal Transverse abdominis plane (SC TAP) block and a novel supraceliac approach to ultrasound guided Celiac Plexus (CP) block was evaluated for its safety and efficacy in providing surgical anaesthesia for open PFJ.Methods: This prospective feasibility study was conducted in ۱۵ patients scheduled for open PFJ. We performed bilateral ultrasound guided SC TAP block and ultrasound guided CP block using a novel supraceliac approach to attain surgical anaesthesia for open PFJ. The variables such as percentage of patients requiring intraoperative and postoperative rescue analgesics and pain scores, block success rate, block performance time, duration of postoperative analgesia and side effects were recorded.Results: Percentage of patients who required rescue analgesics in the intraoperative period and postoperative period were ۶.۶% and ۲۰% respectively, with a block success rate of ۱۰۰%. Intraoperative pain scores measured by verbal rating scale was ۱ in all the patients except one patient who had a score of ۲. Median postoperative pain scores measured by visual analog scale were ۰ for first ۱۲ postoperative hours. The side effects were minimal and manageable.Conclusion: The combination of bilateral ultrasound guided SC TAP block and the novel ultrasound guided supraceliac approach to CP block was a feasible, efficacious, and safe technique to provide surgical anaesthesia for open PFJ in patients with advanced esophageal malignancy.

Anaesthesia, BLOCK, cancer, Celiac plexus, esophagus, Jejunostomy, nutrition