Celiac Plexus Nerve Blocks
Texas Pain Management Institute offers a variety of minimally invasive pain treatment procedures that we have perfected to help you achieve pain relief. Our treatments have been proven effective and are on the cutting edge of science related to pain reduction. Our goal is to improve every patient’s overall function and thus restore a better quality of life.
A celiac plexus block is an injection of local anesthetic into or around the celiac plexus. The celiac plexus is a bundle of nerves located in the abdomen and has been referred to as the “solar plexus” previously. These nerves control painful stimulations coming from the organs in the abdomen such as the pancreas. Normally these nerves control basic nerve functions. However, in certain conditions, these nerves can carry pain information from the gut or abdominal organ tissues back to the spinal cord and brain.
Conditions commonly treated with celiac plexus blocks:
- Abdomen Pain
- Chronic Pancreatitis
- Pancreatic Cancer
- Other abdomen cancers
(please refer to our Pre-procedure Instructions for specifics)
Please arrive 20 minutes prior to your appointment on procedure day. Our nurses will start an IV if you are requesting sedation and take a pre-operative nurse assessment. All patients are taken to the procedure room on a hospital bed. Once in the procedure room you will be given sedation to help make you comfortable. A cold cleaning solution will be placed on your skin to help decrease chances of infection. The procedure site is then identified by your doctor under x-ray guidance. Once the site is identified a shot of numbing medicine (typically bupivicaine) will be given to numb up the skin. This may feel like a bee sting, but will only last a few seconds. The spinal needle is then placed into the position using x-ray guidance. Dye is injected to confirm proper placement of the needle and spread of medication around the celiac plexus. Medication consisting of steroid (methylprednisilone) and local anesthetics (bupivicaine) is injected through the needle. This medication spreads around and bathes the nerves. The same procedure will be repeated on the opposite side to insure all of the celiac plexus is covered. Most patients report profound pain relief quickly. The needle is then removed and you will be taken to the recovery room. The procedure itself takes 10-15 minutes and then you will be observed for another 15 minutes after the procedure. You may then go home and enjoy the rest of your day.
What to expect after procedure:
You may notice an immediate “warm sensation” in your abdomen. You should also notice that your abdomen pain is substantially less or many times disappears completely. We tell most patients to take it easy the rest of the day, but you may return to normal activities as soon as you feel ready. The pain relief may last several days to several months. Some patients require repeat injections for long term pain relief. If the injections works well and takes away a substantial portion of your pain, but simply does not last very long, then you may be a candidate for neurolysis (nerve deadening) with alcohol or phenol. This procedure is repeated as above and is very safe and effective. It is a more long term (6 months or greater) solution if the simple bupivicaine and steroid does not provide long lasting relief.
Celiac plexus blocks are considered an appropriate non surgical treatment for many patients who suffer from severe abdominal pain. The procedure itself is very safe and has been performed for decades. The risks are typically low, but can include misplacement of the needle, bleeding, infection, pneumothorax (collapsed lung), puncture of surrounding organs, puncture of adjacent vessels, drug allergy, nerve damage and/or paralysis. The most common side-effects related to the procedure are hypotension and transient diarrhea.