Hi All, I've been doing a number of celiac blocks and neurolysis lately, seeing a lot of different techniques out there and wondering which technique the illuminati on here recommend. Currently I am favoring a left sided flouro guided technique, using a bent tip 7 inch quinke needle (have a lot of fat patients), c arm at an oblique so the L1 transverse process distal tip lines up with the lateral margin of the L1 vertebral body, coaxial technique. This will usually end up transaortic (just love seeing the needle hub twist back and forth in unison with the pulse, the bent tip acts like a rudder in the stream of blood). Contrast to demonstrate anterocrural position. Usually use 20 cc of marcaine w/epi for block or 10cc Marcaine w/ EPI and 20 cc ETOH. I know the MD anderson boys on SDN do a butt load of these blocks, all opinions welcome... thanks!