الفهرس 
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Abstract
This study was carried on forty patients with pancreatic cancer pain from pain clinic of the National Cancer Institute, Cairo University. Patients were randomly allocated to two groups:
group one: US group (20 patients, scheduled for Neurolytic Celiac Plexus Block (NCPB) by ultrasonic guidance.
group two: C-arm fluoroscopy group (20 patients, scheduled for Neurolytic Celiac Plexus Block (NCPB) by C-arm fluoroscopic guidance (control group).
Visual analogue scale, reduction in daily opioid consumption were recorded before the block, 2 hr, 2 days, 2 weeks and 4 weeks post block, Time of the procedure estimated and encountered side effects were recorded in each group.
All patients were subjected to the following:
• Full history taking.
• Through clinical examination.
• CPB by one of the above techniques.
• Pain assessment (VAS).
• Daily morphine consumption.
• Time of the block.
The data were recorded and statistically analyzed, we found that the mean values of VAS were decreased in the two groups, and there was statistically significant difference between US and C-arm fluoroscopy groups .
The time for inducing the block was significantly shorter for US group in comparison to fluoroscopy group mostly due to the difference in soft tissue definition between US and fluoroscopy which is an advantage for US.
In this study no serious complications occurred but minor complications were reported. Minor complications of CPB include temporary orthostatic hypotension, diarrhea and local pain with no significant difference between US and C-arm fluoroscopy groups.
We concluded that an effective NCPB, regardless of the technique used, produced immediate analgesia and allowed a reduction in opioid dose more significantly observed at group I with evident improvement of opioid induced undesirable adverse effects.
Each technique has its own merits and demerits; yet , US is considered a better imaging technique to document a correct needle tip position, avoiding organ puncture, and in documenting contrast spread. Furthermore, US scanning is useful to define the anatomy especially when anatomic relations of the organs are distorted by tumor or previous operations.