Celiac Plexus Block

A celiac plexus block may help relieve abdominal pain by blocking nerves from transmitting pain messages to the brain.

What is the Celiac Plexus?

The celiac plexus is a bundle of nerves located in the upper abdomen, behind the pancreas and near the aorta. The celiac nerves connect the intestines, gallbladder, pancreas, liver and stomach to the brain and spinal cord. Tumors in the pancreas may cause pain by pressing on and injuring the celiac plexus.

Benefits of a Celiac Plexus Block

Patients with advanced pancreatic cancer often have to take strong pain medicine such as opioids, to alleviate severe abdominal pain. Pain medication does not provide complete pain relief and patients may experience periods of intense pain.

In addition, strong pain medication may cause constipation and other uncomfortable side effects. A celiac plexus block may prevent breakthrough pain, without causing undesirable side effects. Patients who have had a celiac plexus block may be able to lessen their dependence on pain medication.

Side Effects and Risks

The procedure is relatively safe with few temporary side effects such as bruising, soreness and muscle spasms at the injection site, low blood pressure and diarrhea. Serious and rare complications may include:

• Infection
• Collapsed lung
• Bleeding
• Nerve damage
• Delayed gastric emptying
• Allergic reaction to the dye or medication
• Accidental puncture of an organ
• Kidney damage
• Paralysis
• Seizure or lowered blood supply to the spinal cord

Who is a Candidate?

A celiac plexus block may be an effective procedure for individuals with chronic abdominal pain who have not responded to other pain medication. Patients should speak to their physician to find out if a celiac plexus block may help alleviate their pain.

What to Expect During a Celiac Plexus Block Procedure

The procedure may be performed during surgery, an endoscopic ultrasound (EUS), or a simple procedure that involves inserting a needle through the skin.

The patient will be asked to lay down on their stomach on an x-ray table. The physician will then clean the injection site with an antiseptic and numb the area with a local anesthetic. Under x-ray guidance, the physician will insert a thin needle into the back and inject the anesthetic. A second needle will then be inserted into the other side of the spine to inject pain medication. Dye may be used to confirm that the medication has reached the correct spot. The entire procedure may last up to one hour.

After the Procedure

Patients will experience immediate pain relief after the anesthetic is injected. The pain will return once the anesthetic wears off but will be alleviated long-term once the steroid takes effect. Pain relief may last for weeks or months. Some patients may need only two injections, while others may need more than ten.

Patients are allowed to resume their regular diet and take their medication immediately but should refrain from driving or engaging in rigorous activity for 24 hours after the procedure.