Celiac Plexus Nerve Blocks

Our goal is to provide the treatment and pain management our patients need to get back to living. We offer celiac plexus nerve blocks for people suffering from chronic abdominal pain caused by the celiac plexus. Here’s what you should know about this condition. 

The celiac plexus, previously called the solar plexus, is a bundle of nerves located in the abdomen. Typically, these nerves control painful sensations and basic nerve functions from abdominal organs like the pancreas. However, certain conditions can cause them to carry pain signals from the abdominal organ tissues to the spinal cord and brain. 
A celiac plexus block provides relief from some of these painful sensations by injecting local anesthetic into or around the celiac plexus. 

There are several conditions that can cause moderate to severe celiac plexus pain:

Chronic Pancreatitis
Pancreatic Cancer
Other abdomen cancers

Celiac plexus block is especially effective for pain that doesn’t respond to other pain treatments.

On the day of your celiac plexus nerve block, you’ll need to arrive to our clinic 20 minutes early. Our nurses will start an IV if you are requesting sedation and take a preoperative nurse assessment.

All patients are taken to the procedure room on a hospital bed. You will then be given sedation to make you comfortable before the procedure begins. 

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 the 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.

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.