4. INDICATIONS
• Acute or chronic pancreatitis
• Pancreatic cancer
• Intra abdominal METs disease
• Diagnostic block: visceral vs. abdominal wall pain
• Adjunct to surgery
11. COMPLICATIONS
• 0.15-1.0% complication rate
• Pneumothorax
• Chylothorax
• Nerve injury including paralysis
• Retroperitoneal fibrosis
• Aterial vasospasm resulting in ASA syndrome
• Common
• 96% local pain
• 44% diarrhea
• 38% hypotension
12. SUCCESS RATE
• Eisenberg et al:
• Adequate-excellent pain relief within first week: 89%
• 70-90% continued to have pain relief at 3 months
13. REFERENCES
Eisenberg E, Carr DB, Chalmers TC. Neurolytic celiac plexus
block for treatment of cancer pain: a meta-analysis. Anesth
Analg. 1995;80:290-295.
Mercadante S, Nicosia F. Celiac plexus block: a reappraisal. Reg
Anesth Pain Med. 1998;23:37-48.
Ward EM, Rorie DK, Nauss LE, et al.The celiac ganglion in man:
normal anatomic variations. Anesth Analg 1979;58:461
Ischia S, Luzzani A, Ischia A, et al. A new approach to the
neurolytic block of the coeliac plexus. The transaortic technique.
Pain 1983;16:333.
Editor's Notes
LEFT SITE: 2/3 DOWN L1RIGHT SITE: 1 CM ABOVE L1
Small triangle: 12th rib, T12, L1Lateral point should be 6-9cm from midline (12th rib and paraspinal muscles)LEFT SIDE:Insert needle 45 degrees from the coronal plane and 15 degrees cephaladAdvance about 8-10 cm untill hit L1 vert bodyWithdraw almost subQ, then reangle 10 more degrees lateral and readanceShould hit bone now at 10-13cmRepeat until you walk off the vertebral body and land 1cm anterior to itWill feel/see needle pulsationsNow insert a second needle on the right and spread contrast
