Overview of Celiac Plexus Block in Houston

A celiac plexus block is an injection of pain medicine to help with abdominal pain, which is often due to chronic pancreatitis or cancer. The celiac plexus is a bundle of nerves that surrounds the main artery of the abdomen, which is called the aorta, and these nerves come from the stomach, pancreas, liver, and bowels.

Located underneath the diaphragm in the center of the abdomen, these nerves are injected with numbing medicine that decrease pain feeling. The block prevents the nerves from carrying pain sensations to the brain from the abdomen.

How the Procedure is Done 

This procedure is done by using intravenous medication to relax the patient. While lying on the stomach of the exam table, the doctor inserts a thin needle near the spine and injects anesthesia medicine. After this, a second needle is placed on the other side. With dye injected to confirm proper position, the doctor will inject the pain medicine, such as clonidine, epinephrine, or a steroid. Also, phenol or alcohol is often used to destroy nerve tissue. The total procedure only takes around 30 minutes and then the patient can go home.

Effectiveness of the Celiac Plexus Block 

The celiac plexus block lasts several weeks to months. For some people, the relief starts immediately, but for others, pain is not lessened until two more injections are given. Also, the celiac plexus block series can offer relief to the patient that lasts several years.

What are the Risks of Celiac Plexus Block? 

There are a few risks of the celiac plexus block. They usually do not occur, but include:

  • Low blood pressure
    •    Infection
    •    Collapsed lung
    •    Nerve damage
    •    Bleeding
    •    Diarrhea

Before the Procedure 

The pain specialist is an anesthesiologist who assesses your pain, takes a medical history, and performs an exam that is focused on your symptoms. After the first visit, you get two appointments, and one is for a diagnostic block and the other is for a neurolytic, long-term celiac plexus block. Be sure to not eat or drink after midnight before the procedure, and take sips of water only with your medication the day of the procedure.
After the Procedure 

After the procedure, the abdomen will feel “different” and a little warm. Also, the patient starts to have some relief from the abdominal pain. Also, the abdominal wall and leg(s) may be weak, feel numb, or tingle. The patient is urged to continue on prescribed medications and regular diet, but cannot drive or do rigorous activity for 24 hours following the procedure. The nerve block usually lasts several days, but with a repeat injection, the effects can persist. The diagnostic block allows you to receive pain relieve for at least two months. Many patients take some pain medicines after the celiac plexus block, but the frequency and dose is less. Discuss this with your doctor before your procedure.
Candidates for Celiac Plexus Block 

The celiac plexus block is best for the patient with chronic abdominal pain, which is related to cancers or chronic disease. The chance of the block working is best if you have had this procedure at an earlier time. For some patients, a neurolytic celiac plexus block is best. This treatment is concentrated alcohol with numbing medication which is used to destroy nerve fibers and allow the patient to be pain free.

References

Kambadakone A, Thabet A, Gervais, DA, Mueller, PR, & Arellano, RS (2011). CT-guided celiac plexus neurolysis: a review of anatomy, indications, technique, and tips for successful treatment. Radiographics, 31(6), 1599-1621.