Complications of sympathetic blocks for visceral pain

Sympathetic blocks for viscerally mediated abdominal pain are a useful adjunct to control pain in appropriately selected patients. Complications from these blocks include infection, bleeding, puncture of nearby structures, or nerve injury. Infectious complications may be minimized by the use of sterile technique including chlorhexidine prep and the use of surgical masks by the practioners. Bleeding and inadvertent puncture of nearby organs may be decreased by utilizing blunt needles and appropriate imaging. The use of neurolytics may cause complications secondary to the inadvertent spread of the injection to nearby structures or intravascular injection. These complications may be decreased through injection of contrast during live fluoroscopy. In addition, technologies of radiofrequency ablation may help to decrease concerns of spread of neurolytics. Despite significant risks, these blocks have been shown to not only decrease pain but also increase quality of life in appropriately selected patients.