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Autonomic Insufficiency After Neurolytic Celiac Plexus Block

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Challenging Cases and Complication Management in Pain Medicine

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Abstract

Celiac plexus blockade and neurolysis are used to treat pain of the upper abdomen, most commonly the pancreas. The celiac plexus is a collection of visceral, sympathetic, and parasympathetic nerves, and thus blockade results in autonomic effects and analgesia. The most common side effects are transient hypotension, possibly from inhibition of splanchnic vasoconstriction and/or spread of injectate to thoracic sympathetic nerves, and transient diarrhea, from increased peristalsis. Other less common autonomic side effects include chronic diarrhea, sexual dysfunction, and gastroparesis. Liberal intravenous fluids and patient education are recommended for the more common side effects; reports of successful treatment of less common side effects are also presented.

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Author information

Authors and Affiliations

  1. Department of Neurosurgery, University of Texas Health Science Center, Houston, TX, 77030, USA

    Mark J. Burish M.D., Ph.D.

  2. Division of Pain Medicine Clinical Fellow, PGY-5, Department of Anesthesia and Perioperative Care, University of California at San Francisco, San Francisco, CA, 94143, USA

    Ryan Mattie M.D.

  3. Pain Physician and Anesthesiologist, Mt Tam Orthopedics, Medical Director of Pain Management for Marin General Hospital, Novato, CA, 94945, USA

    Ramana K. Naidu M.D.

Authors
  1. Mark J. Burish M.D., Ph.D.
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  2. Ryan Mattie M.D.
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  3. Ramana K. Naidu M.D.
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Corresponding author

Correspondence to Ramana K. Naidu M.D. .

Editor information

Editors and Affiliations

  1. Department of Anesthesia and Critical Care, University of Chicago Medicine, Chicago, Illinois, USA

    Magdalena Anitescu

  2. Department of Anesthesiology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA

    Honorio T. Benzon

  3. Division of Pain Medicine, Department of Anesthesiology, University of California San Diego School of Medicine, La Jolla, California, USA

    Mark S. Wallace

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Burish, M.J., Mattie, R., Naidu, R.K. (2018). Autonomic Insufficiency After Neurolytic Celiac Plexus Block. In: Anitescu, M., Benzon, H., Wallace, M. (eds) Challenging Cases and Complication Management in Pain Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-60072-7_22

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  • DOI: https://doi.org/10.1007/978-3-319-60072-7_22

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