Celiac Plexus Block

A Celiac plexus block is a medical procedure in which a local anesthetic and medication are injected into the celiac plexus. The celiac plexus is represented by a bundle of nerves, which are located in the center of the abdomen, near the aorta and other blood vessels. The main purpose behind this procedure is to block the pain signals that are transmitted from the territories innervated by the celiac plexus (abdominal area) to the brain.

The celiac plexus block is recommended in patients who have been diagnosed with chronic pancreatitis and chronic abdominal pain, caused by different types of cancer. The procedure is performed with intravenous sedation, as it can be quite painful, due to the fact that the doctor will need to reach the deeper tissues. In case the patient does not respond to the first injection, a further injection is going to be recommended. As the response to the procedure varies from one patient to the other, there are no set numbers of injections recommended. In general, relief from the symptoms is provided after 2-10 injections.

Technique

Before the actual procedure, you will be administered intravenous anesthetics, so that you become relaxed and tolerate the procedure, without any pain or discomfort. You will be lying on your back, while the doctor applies a local anesthetic to the point of entry. Using guided X-raying (fluoroscopy), the doctor will insert a thin needle and deliver the pain medication to the respective site. Among the medication that can be administered, there are: epinephrine, corticosteroids or clonidine. The doctor might also decide to administer alcohol or phenol. The injection can last between ten and thirty minutes to be completed.

Is Celiac plexus block effective?

As it was already mentioned, the celiac plexus block has as main purpose the blockage of pain signals from the abdominal area to the brain. The pain relief provided by this procedure vary from one person to the other. In some patients, the pain relief can last for several weeks, while in others the period of pain relief might extend to a couple of years. The procedure can contribute to a great improvement in the overall quality of life, allowing patients to resume their daily activities and even return to work. The efficiency of this procedure can be increased by repeating the injections, according to the recommendations made by the doctor.

Procedure

The celiac plexus block is a procedure that is done with intravenous sedation, so as to ensure the highest level of tolerance for the patient. In order to identify the exact location of the injection, the doctor will use fluoroscopy or guided X-rays. For the visualization of the injection site to be possible, the doctor will inject radiographic dye first. Then, he/she will administer the medication for pain relief. The procedure lasts for about half an hour, provided there are no complications. In the majority of the cases, the patient is allowed to go home in the same day.

During the procedure, the vital signs of the patient are monitored. The doctor will monitor the activity of the heart, the pulse and the breathing capacity.

How long does it take for a celiac plexus block to work?

As the doctor also injects a local anesthetic, the pain relief is immediate and this effect lasts for a couple of hours. The celiac plexus block remains effective for a couple of weeks to several years. It should be noted that the efficiency of the celiac plexus block increases after each injection.

What to expect after a celiac plexus block?

Immediately after the procedure, you might experience a sensation of warmth at the level of the abdomen and a reduction in the pain intensity (due to the local anesthetic). Temporary side-effects that may appear with the celiac plexus block include: temporary weakness, numbness sensation in the abdominal wall, similar sensations at the level of the leg.

Given the fact that you have been sedated, it is important to have someone waiting to take you home. During the first days after the procedure, the doctor will recommend that you avoid intense physical effort. It is for the best that you stick with the activities that you can tolerate, meaning those that cause no discomfort or pain. Physical therapy might be recommended after the celiac plexus block, promoting a better and a faster recovery.

It is difficult to predict how much the celiac plexus block helps, as each patient has a different response to the administered treatment. The response might be reduced in patients who have suffered from health problems at the level of the abdomen for prolonged periods of time or in those who have been diagnosed with severe cases. The doctor can provide the most accurate information about the expected response, upon the performing of the celiac plexus block.

The doctor will also talk to you about the potential contraindications that this procedure presents. These contraindications include: taking certain medication (blood thinners), suffering from diabetes (severe forms), and the presence of infection at the level of the body (active state). In these situations, the doctor might decide to postpone the celiac plexus block, until it is safe for this procedure to be performed. As for medication, you might be required to stop taking the medication prior to the procedure, so as to reduce the risk of hemorrhage.

In general, the celiac plexus block is a relatively safe procedure. However, for the first couple of days after the procedure, you might feel pain or soreness at the site of injection. In rare cases, the following complications might occur: bleeding, infection, nerve injury, damage to the surrounding blood vessels, collapsed lung. The complications are often the result of misguided applications. As for the other side-effects of this procedure, this might include the hypotension and the change in the bowel movements (diarrhea). Nevertheless, you must remember that these side-effects are temporary, going away on their own.

In conclusion, the celiac plexus block is a recommended procedure to all patients who suffer from chronic abdominal pain, due to different types of cancer or other chronic conditions. It is especially indicated in those who have failed to respond to other types of treatment, improving the overall quality of life.