Celiac Plexus Block
The celiac plexus is a bundle of nerves located in your upper abdomen. It’s behind the stomach near the celiac artery and the abdominal aorta. The celiac plexus connects nerves from the liver, pancreas, gallbladder, stomach, spleen, and kidneys to your brain and spinal cord.
When pain occurs in one of these organs, often due to a tumor or other damage, a celiac plexus block can help relieve that pain. A celiac plexus block is an injection that delivers pain medication as well as a medication that destroys or damages the nerves for longer-lasting pain relief.
Celiac plexus blocks are a minimally invasive treatment option that can relieve severe pain for many people. This pain relief allows many people to resume their normal daily activities.
The most common use of celiac plexus blocks is for upper abdominal pain, including pain related to: metastatic cancer in the abdomen, chronic pancreatitis, and/or liver tumors.
Cancer pain can intractable and unresponsive to most pain treatments, but research indicates that celiac plexus blocks can help with this form of pain. For patients with pain that is unresponsive to other treatments, or who suffer from serious side effects from cancer treatments, celiac plexus blocks reduce pain and can increase your overall quality of life. These results were especially pronounced when doctors used CT scans or other computerized aids to help properly place the block.
Celiac plexus block benefits can be temporary for some people, but the amount and duration of pain relief varies from person to person. Some experience pain relief for weeks. Others can benefit from the block for years. Fortunately, the procedure is a low-risk, non-surgical treatment that, if successful the first time, will most likely continue to provide pain relief with repeated treatments.
The first step of a celiac plexus block is a consultation with your doctor, who will explain the procedure and answer your questions. For the procedure itself, you lie flat on your belly on an examination table. Your doctor applies a topical anesthetic to numb the area. Sometimes your doctor recommends intravenous sedation to make the procedure more comfortable.
Using X-ray guidance, your doctor inserts a thin needle next to your spine. When the tip is in the correct position, a second needle is placed on the opposite side of the vertebrae. Contrast dye and local anesthetic are injected. If the needle and the block are properly administered, you will experience nearly instantaneous and profound pain relief.
Your doctor may also inject another medication (alcohol or phenol) that destroys the celiac nerves for longer-lasting pain relief.
The entire procedure usually takes less than 30 minutes. Your physician will monitor your pain and vital signs (pulse, blood pressure, temperature) after the procedure.
Celiac plexus blocks are an appropriate non-surgical treatment for many patients who suffer from severe abdominal pain. The risks for the procedure are typically low, but as with any procedure, there can be side effects. Most of these are due to misplacement of the needle and could include the following: bleeding, infection, collapsed lung (pneumothorax), puncture of surrounding organs, puncture of adjacent vessels, drug allergy, nerve damage and/or paralysis.
An experienced doctor’s use of X-ray guidance can help prevent many of these side effects. The most common side effects related to the procedure itself are hypotension and transient diarrhea.
Celiac plexus recovery is usually easy and marked by profound pain relief. After your procedure, you may feel warmth spreading in your abdomen. This is the movement of the medication across the celiac plexus. Take it easy for 24 hours following the procedure. Have someone drive you home from your appointment and rest for the remainder of the day. Avoid heavy lifting or strenuous physical activity.
You can eat and drink as normal immediately following the celiac plexus block procedure. After checking with your doctor, continue to take your regular medications as normal. Your belly may feel weak or numb, and you may experience mild numbness in your legs, but this is due to the anesthetic. Once the anesthetic from the procedure wears off, feeling should return to these areas.
