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.