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CELIAC PLEXUS BLOCK
Picture
The needle is advanced toward the T12-L1 interspace in AP view. A turn to lateral on fluoroscopy is performed when the needle slips under the vertebral body.
Picture
The needle is advanced through the aorta carefully. Once no blood is obtained with aspiration, contrast is obtained to ensure is no vascular uptake.
Picture
Prior to injecting the local anesthetic, a turn to AP view on fluoroscopy can demonstrate the extent of the contrast spread. This can help determine if the contralateral side needles to be blocked.
 The celiac plexus block is traditionally performed using fluoroscopy in the posterior approach.   A unilateral left-sided approach can be done with sufficient anesthetic spread around the plexus.  For the procedure, the following are useful:
  •  Lidocaine 1% 10mL
  •  Bupivacaine 0.25% 30mL (with epinephrine)
  •  Iodinated contrast agent
  • 22-gauge 7 inch spinal needle (a 5 inch may be used if the patient is very thin but this risks having to hub the needle to access the appropriate location)
  •  25 -gauge 1.5 inch regular bevel needle
  •  18-gauge 1 inch regular bevel needle
  •  20mL syringe x 1
  •  10mL syringe x 2
  •  5-mL syringe x 1
  •  small bore extension IV extension set (tubing)
  •  gauze
  •  drapes
  •  sterile gloves
  •  adhesive dressing

 After the patient is laid in the prone position, a wide prep is done around the midback.  Fluoroscopy is utilized to visualize T12-L1 interspace in the AP view, ensuring the endplates are squared.  
​
CELIAC PLEXUS BLOCK WITH FLUOROSCOPY - OERATIVE REPORT TEMPLATE
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  • ABOUT
  • INTERVENTIONS
    • EPIDURAL INJECTIONS >
      • CAUDAL EPIDURAL INJECTIONS
      • INTERLAMINAR EPIDURAL INJECTIONS >
        • CERVICAL INTERLAMINAR EPIDURAL INJECTIONS
        • THORACIC INTERLAMINAR EPIDURAL INJECTIONS
        • LUMBAR INTERLAMINAR EPIDURAL INJECTIONS
      • TRANSFORAMINAL EPIDURAL INJECTIONS
    • JOINT & BURSA INJECTIONS >
      • SYNOVIAL FLUID ANALYSIS
      • Hip Injection
      • Knee Injection
      • Sacroiliac Joint Injection
      • TROCHANTERIC BURSA INJECTION
    • KYPHOPLASTY
    • LUMBAR DECOMPRESSION >
      • LUMBAR DECOMPRESSION
      • MINIMALLY INVASIVE LUMBAR DECOMPRESSION (MILD)
    • MUSCLE & TENDON INJECTIONS >
      • CARPAL TUNNEL INJECTION
      • PLANTAR FASCIA Injection
      • TRIGGER POINT INJECTION
    • NERVE BLOCKS >
      • CLUNEAL NERVE BLOCKS
      • SYMPATHETIC BLOCKS >
        • CELIAC PLEXUS BLOCK
        • GASSERIAN GANGLION BLOCK
        • LUMBAR SYMPATHETIC BLOCK
        • SPHENOPALANTINE GANGLION BLOCK
        • STELLATE GANGLION BLOCK
    • NEUROMODULATION >
      • INTRATHECAL DRUG DELIVERY PUMP
      • NERVE STIMULATION
    • RADIOFREQUENCY ABLATION
    • REGENERATIVE PROCEDURES
    • SACROILIAC JOINT FUSION
  • PHARMACEUTICALS
    • ANTIDEPRESSANTS
    • ANTICONVULSANTS
    • Clinical Drug Monitoring
    • LAXATIVES
    • Interventional Pharamacology >
      • RADIOGRAPHIC CONTRAST AGENTS
      • LOCAL ANESTHETICS
      • CORTICOSTEROIDS
      • TOPICAL ANTISEPTICS
    • Intravenous Infusion Therapy
    • MUSCLE RELAXANTS >
      • DANTROLENE
  • CONDITIONS
    • Ankylosing spondylitis
    • CROHN'S DISEASE
    • COMPLEX REGIONAL PAIN SYNDROME
    • Fibromyalgia
    • Headache >
      • Cluster Headache
      • Migraine Headache
      • Other Headache
      • Tension-Type Headache
    • Insomnia
    • Myofascial Trigger Points
    • OSTEOMYELITIS
    • Pancreatitis
    • Plantar Fasciitis
    • Poststroke
    • RHEUMATOID ARTHRITIS
    • Sickle Cell Disease
    • Systemic Lupus Erythematosus
  • SYMPTOMS
    • Abdominal Pain
    • PELVIC PAIN
  • MISCELLANEOUS
    • CODES: CPT and ICD
    • Hormone Testing
    • JOKES
    • PERIOPERATIVE CONSIDERATIONS