Ultrasonic guidance of lumbar sympathetic and celiac plexus block: a new technique

Lumbar sympathetic and celiac plexus block are widely used to treat chronic pain of diverse etiologies. To avoid complications and confirm the correct position of the needle, fluoroscopy and computed tomography have been used to follow the procedure visually. Our objective was to examine whether ultrasonography could be used instead of these techniques.

Forty-eight neurolytic sympathectomies were performed using ultrasonographic guidance. The results were evaluated clinically and by color-doppler technique as applicable.

This new technique was shown to provide excellent results in ensuring the safe passage of the needle and documenting the correct spread of neurolytic agent (phenol-glycerol). The correct position of the needle was achieved on the first attempt in all cases.

The benefits of this technique are that it is inexpensive, there is no radiation, and the anatomy involved can be thoroughly examined before and after the procedure. Phenolglycerol may be the best choice as the neurolytic agent because it provides excellent contrast.