• Julia K LeBlanc, Jon DeWitt, Cynthia Johnson, Wycliffe Okumu, Kathleen McGreevy, Michelle Symms, Lee McHenry, Stuart Sherman, and Thomas Imperiale.
• Division of Gastroenterology and Hepatology, Indiana University Medical Center, Indianapolis, Indiana 46202, USA. juleblan@iupui.edu
• Gastrointest. Endosc. 2009 Apr 1;69(4):835-42.

BackgroundThe efficacy of 1-injection versus a 2-injections method of EUS-guided celiac plexus block (EUS-CPB) in patients with chronic pancreatitis is not known.ObjectiveTo compare the clinical effectiveness and safety of EUS-CPB by using 1 versus 2 injections in patients with chronic pancreatitis and pain. The secondary aim is to identify factors that predict responsiveness.DesignA prospective randomized study.InterventionsEUS-CPB was performed by using bupivacaine and triamcinolone injected into 1 or 2 sites at the level of the celiac trunk during a single EUS-CPB procedure.Main Outcome MeasurementsDuration of pain relief, onset of pain relief, and complications.ResultsFifty [corrected] subjects were enrolled (23 received 1 injection, 27 [corrected] received 2 injections). The median duration of pain relief in the 31 responders was 28 days (range 1-673 days). [corrected] Fifteen [corrected] of 23 (65%) [corrected] subjects who received 1 injection [corrected] had relief from pain compared with 16 of 27 (59%) [corrected] subjects who received 2 injections [corrected] (P = .67). [corrected] The median times to onset in the 1-injection and 2-injections groups were 21 and 14 days, respectively (P = .99). No correlation existed between duration of pain relief and time to onset of pain relief or onset within 24 hours. Age, sex, race, prior EUS-CPB, and smoking or alcohol history did not predict duration of pain relief.LimitationTelephone interviewers were not blinded.ConclusionsThere was no difference in duration of pain relief or onset of pain relief in subjects with chronic pancreatitis and pain when the same total amount of medication was delivered in 1 or 2 injections during a single EUS-CPB procedure. Both methods were safe.

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