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.

The needle is advanced through the aorta carefully. Once no blood is obtained with aspiration, contrast is obtained to ensure is no vascular uptake.

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
File Size:	13 kb
File Type:	docx

Download File

---