How is a
celiac plexus block performed and what complications can occur?
Celiac plexus blocks are performed under either
fluoro-scopic or computerized tomography (CT) scan guidance. The patient is
placed in the prone position unless they can-not tolerate it because of ascites
or other intra-abdominal processes. The plexus lies anterior to the aorta and
poste-rior to the vena cava. A needle is placed from each side to lie anterior
to the body of L1. Dye injection confirms nee-dle placement in the
retroperitoneum. A maximum of 40 mL of either local anesthetic or neurolytic
agent is injected.
Complications that can occur with celiac plexus
block-ade include hypotension, injury to adjacent viscera (e.g., kidneys,
pancreas, pleura, lung, aorta, and intestines), lower extremity dysesthesias or
motor dysfunction, intravascular injections, retroperitoneal hematomas, and
intrathecal, epidural, intrapsoas, or intraosseous injections. As is the case
with any invasive procedure, sterile technique is imper-ative to avoid
infection, especially in the cancer patient who may be immunosuppressed.
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