Sympathetic Plexus Blocks

It is a complex network of nerves whichextremities. It has been implicated in neuropathic pain, vascular, and visceral pain . Lumbar plexus islocated anterior to L2-L3 vertebral body.

Among many indications the listed are the main indications: vascular insufficiency, CRPS 1 or 2,neuropathic lower limb pain, cancer pain, rectal tenesmus from cancer, intractable back pain, diabetic foot ulcer (to improve healing, blood flow, and decrease pain).

The sympathetic nerve becomes hyperactivity due to chronic pain. With the LSPB is goal is to break the cycle of pain and decrease sympathetic outflow, and thus, allow more blood flow. This helps to desensitize the nerve fibers, increase blood flow, increase healing (due to increased blood flow) and decrease pain.

Among many, here are few listed: bleeding, intravascular injection, intrathecal or epidural injection,perforation of viscera, groin pain (genitofemoral nerve injury).

After sterile preparation of the back region, the injection site if localized under X-ray. Following the local anesthetic applied to the injection site, which can help decrease the injection site pain, the needle is guided toward the target site (anterior to L3 vertebral body) with the help of X-ray. After the target is localized, it can be further confirmed with liquid contrast, which can help further confirm the location of the lumbar plexus. After the lumbar plexus is confirmed, the local anesthetic medication is injected, and the needle is taken out at the end of the procedure.

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