FAQs on Celiac Plexus Block in Nashville

The celiac plexus is a bundle of nerves positioned behind the stomach and directly in front of the diaphragm. These nerves supply various organs of the abdomen, such as the liver, gall bladder, stomach, and intestines. A celiac plexus block is an interventional pain procedure used to treat abdominal pain.

Why is the celiac plexus block used?

Nerve blocks are used to relieve the pain associated with serious health conditions. The celiac plexus block is reserved to treat intense, severe, and intractable abdominal or pelvic pain that does not respond to pain medicines or other treatments. The block is used most commonly to treat pancreatic cancer. However, pain management specialists use the celiac plexus block for chronic functional abdominal pain (FAP).

How do I prepare for the procedure?

The Nashville pain management specialty center will inform you of where and when to report for the celiac plexus block procedure. You should not eat or drink after midnight the night before the procedure. Be sure to ask the doctor which medications you are allowed to take the morning of the procedure, and only take the medicines will small sips of water. Additionally, avoid using any long-acting pain medications the day of the celiac plexus block.

What happens before the celiac plexus block procedure?

The day of the procedure, a nurse will explain the procedure to you and have you sign a consent form. A nurse will start an intravenous (IV) catheter in your arm, and you may be given a mild sedative. You will be taken to the surgical room and positioned on your stomach. The back is cleansed with an antiseptic solution. The assistants will attach monitoring devices to your body, to assess your blood pressure, oxygen, and heart rhythm.

How is the celiac plexus block performed?

The pain management doctor in Nashville will anesthetize the skin of the back with an anesthetic before inserting small needles through the soft tissues of the back, which are then guided to one side of the vertebrae. These needles are positioned near the celiac plexus nerves using x-ray guidance (fluoroscopy).

To locate the celiac plexus, a contrast dye is injected onto the nerves. For the block, the doctor will inject an anesthetic, and sometimes, a neurolytic substance (alcohol or phenol) is used to destroy a portion of the nerves. The entire procedure usually takes less than 30 minutes.

What happens after the procedure?

Once the celiac plexus block has been performed, you are moved to a recovery area, where you will be observed for a short while for any adverse reactions or medication side effects. Once stable, you will be released home, but should bring someone to drive you, as driving is not permitted for 24 hours.

Are there any risks associated with the celiac plexus block?

There are a few risks and complications associated with the celiac plexus block, as it is a minimally invasive procedure. However, most patients have no problems. The risks include infection, drug allergy, pneumothorax, bleeding, blood vessel injury, and nerve damage. The most common side effects for this procedure are temporary low blood pressure and mild diarrhea.

What are the benefits of the celiac plexus block?

The celiac plexus block prevents the transmission of pain signals to the brain, where they are interpreted as pain sensations. For patients with severe or intractable pain, this block is associated with reduced reliance on pain medication and enables patients to resume regular activities. The duration of pain relief varies from patient to patient. Many people enjoy pain relief that last for years with just one block, whereas others experience pain relief for a few weeks.

Does the celiac plexus block work?

According to clinical studies, the celiac plexus block is effective for relieving chronic abdominal pain, especially that due to malignancies. Severe abdominal pain often does not respond to oral medications. According to two recent controlled trials, the efficacy rate of this block is 85-90%. Pain control is often sustained for long periods of time, and the celiac plexus block can be repeated as necessary.

Resources

Erdine, S (2005). Celiac ganglion block. Agri, 17(1):14-22 PMID: 15791495.

Vorenkamp, KE & Dahle, NA (2011). Diagnostic celiac plexus block and outcome with neurolysis. Pain Management 15,(1), 28-32. DOI: http://dx.doi.org/10.1053/j.trap.2011.03.001

Yan, BM & Myers RP (2007). Neurolytic celiac plexus block for pain control in unresectable pancreatic cancer. Am J Gastroenterology, 102(2):430-8. Epub 2006 Nov 13 PMID: 17100960.