FAQs on the Celiac Plexus Block in Colorado

 

A celiac plexus block is an injection of an anesthetic or neurolytic agent onto the nerves that supply to abdominal region. This block is used to relieve chronic abdominal pain from serious illnesses.

What is the celiac plexus?

The celiac plexus is a bundle of nerves that surround the main artery that spurs off the heart and supplies the abdomen (called the aorta). Blocking the nerves of this bundle will stop the pain sensations of the abdomen.

What do I prepare for the celiac plexus block?

When you visit the Colorado pain management specialist about your chronic abdominal condition, the doctor will take a medical history, ask questions about your pain, and conduct a thorough examination. Once the doctor determines the celiac plexus block would work for your pain, the doctor explains the procedure and has you sign a consent form.

Because bleeding could occur, you should not take any medications that thin the blood for 7-14 days before the procedure. These drugs include aspirin, non-steroidal anti-inflammatory drugs, Coumadin, Heparin, and Plavix. If you have a heart condition that requires you to take a blood thinning agent, you should not have this procedure. Do not eat or drink after midnight the night before your scheduled procedure, and leave all valuables at home when you go to your appointment.

How is the celiac plexus block done?

When you arrive at the medical center, a nurse had you change into a procedure gown, attaches monitoring devices to your arm and finger, and places an IV catheter in your hand. You are positioned on your stomach side on the procedure table, and the doctor cleans your skin with an antiseptic solution. Afterwards, the doctor uses a fine tiny needle to numb the skin of your back.

Using fluoroscopy guidance, the procedure needle is inserted through the skin, fat, and muscle, and positioned near the celiac plexus nerve bundle. A second needle is inserted on the other side of the spine, and dye is injected to confirm the medication will go to the right spot. Then, an anesthetic, corticosteroid, clonidine, and/or epinephrine is injected. The doctor may use a neurolytic agent to destroy the nerves, but they do grow back.

What can I expect after the celiac plexus block?

Pain relief for some patients is immediate, especially when a local anesthetic is used. The abdomen may feel “different,” warm, and you may have minor nausea. The abdominal wall often feels week, but this resolves in 10-30 minutes. The nerve block can last from several days to months, depending on the agent used, how well you respond, and the severity of your condition. You will be monitored in the recovery area for around 1-2 hours before being discharged home.

Who is a candidate for the celiac plexus block?

A celiac plexus block is used to treat people with chronic abdominal pain, especially those associated with cancers. The block is also used to treat conditions like chronic pancreatitis. The celiac plexus block can treat abdominal pain by inhibiting the transfer of pain signals from the abdominal organs and the spinal cord and the brain.

Does the celiac plexus block work?

According to many clinical studies, the celiac plexus block works. A recent study found the efficacy rate of this block to be 83%. Other studies show success rates of 73-90%. In clinical trials, the celiac plexus block was used for pancreatic cancer and chronic pancreatitis.

Resources

Bahn BM, Erdek MA. Celiac Plexus Block and Neurolysis for Pancreatic Cancer. Curr Pain Headache Rep. 2013;17;310.

McGreevy K, Hurley RW, Erdek MA, Aner MM, Li S, Cohen SP. The effectiveness of repeat celiac plexus neurolysis for pancreatic cancer: A pilot study. Pain Pract. 2013;13(2):89-95.

Yan BM, Myers RP. Neurolytic celiac plexus block for pain control in unresectable pancreatic cancer. Am J Gastroenterol. 2007;102(2):430-8.

Zhong W, Yu Z, Zeng JX, Lin Y, Yu T, Min XH, Yuan YH, Chen QK. Celiac plexus block for treatment of pain associated with pancreatic cancer: A meta-analysis. Pain Pract. May 2013.

Zou XP, Chen SY, Lv Y, Li W, Zhang XQ. Endoscopic ultrasound-guided celiac plexus neurolysis for pain management in patients with pancreatic carcinoma reasons to fight a losing battle. Pancreas. 2012;41(4):655-7.