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Lumbar Sympathetic Block

PROCEDURE: Bilateral lumbar sympathetic block.

ANESTHESIA: Local sedation.

VITAL SIGNS: See nurse’s notes.

COMPLICATIONS: None.

DETAILS OF PROCEDURE: INT was placed. The patient was in the prone position and the back prepped with Betadine. The patient was given sedation and monitored. Xylocaine 1.5% for skin wheal 6 cm lateral and slightly inferior to the bilateral L2 transverse process was made. A 20-gauge, 15 cm LSB needle was then directed using AP and lateral fluoroscopic guidance until the tip of the needle was just inside the lateral aspect of the vertebral body and on the lateral projection, it was noted to be along the anterior vertebral body, at the junction of the upper two thirds, lower one third of the body. After negative aspiration 3 cc of Omnipaque dye was injected showing linear spread along the body. After negative aspiration 18 cc of 0.25% Marcaine was injected. Attention was then directed to the L3 level with the tip of the needle guided to the junction of the upper one third, lower two third of L3. At this point, after confirmation of the linear spread of dye along the anterior portion of the body, negative aspiration was performed and 18 cc of 0.25% Marcaine was injected. Neosporin and band-aids were applied over the sites. The patient was taken to the outpatient recovery room in stable condition.

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