FAQs on Celiac Plexus Block

The celiac plexus block (CPB) is a minimally invasive procedure used to manage intractable, severe abdominal pain. The doctor injects medication onto targeted nerves in order to block pain signal transmission.

What conditions are treated with the celiac plexus block?

CPB is used for the management of pain related to abdominal cancer, pancreatic cancer, chronic pancreatitis, cholangiocarcinoma, abdominal visceral pain, retroperitonea malignancies, and biliary sphincteric disorder. Visceral organ pain is often related to malignancies, and this pain is difficult to treat, as it does not always respond to oral medicines.

What is the celiac plexus?

The celiac plexus is a nerve bundle located behind the stomach and near the large aortic blood vessel of the abdomen. This structure supplies the organs of the abdomen, such as the liver, pancreas, gallbladder, spleen, kidneys, adrenal glands, and stomach. The plexus is a complex nerve network, and involves small nerves that carry pain signals from the organs to the brain.

How do I prepare for the celiac plexus block procedure?

Because a sedative is usually given, arrange to have someone to drive you home. When you arrive at the surgical facility, a member of our staff goes over the risks and benefits of the procedure, and asks you to sign a consent form. After changing into a gown, the nurse starts an intravenous line (IV) in your arm and attaches monitoring devices to your body. These devices monitor blood pressure, oxygen level, and pulse.

What can I expect during the procedure?

A nurse administers a mild sedative through your IV catheter, and you will be positioned on your stomach and draped. The doctor numbs your skin using a mild anesthetic, and inserts a needle near the targeted nerves using x-ray imaging and contrast dye to assure correct placement. A long-acting anesthetic and/or neurolytic agent is injected onto the nerve bundle. In all total, the procedure takes around 30 minutes to perform.

What can I expect after the celiac plexus block?

After the procedure, you are moved to a recovery room, and a nurse monitors you for around 30 minutes. Expect to have some soreness at the injection site, but this resolves after a few minutes. We recommend that you rest for the remainder of the day, take it easy for several days, and gradually return to usual activities.

What are the benefits of the celiac plexus block?

Most patients who receive this block have a reduced need for pain medication and improved pain control. Many patients enjoy improvement in mobility and return to normal activities. According to clinical studies, the celiac plexus block offers moderate pain relief. However, the duration and character of this relief varies from person-to-person. Studies show that CPB is more effective than other procedures for relieving pain.

What are the risks and complications associated with this procedure?

Most simple medical procedures are associated with some risks. While rare, the risks associated with the celiac plexus block include nerve damage, blood vessel damage, drug reaction, bleeding, puncture of abdominal organs, and collapsed lung.

What expected side effects are associated with the block?

Most blocks have side effects. With the celiac plexus block, the side effects include back pain, diarrhea, and low blood pressure. However, not all patients have these side effects, and these issues are only temporary.

Is the celiac plexus block effective?

Numerous studies support the effectiveness of celiac plexus blocks. These blocks allow patients to achieve good pain control, with a success rate of 85-90%. The pain relief associated with the block lasts for several months, and the procedure can be repeated. Celiac plexus blocks are used for terminal patients to improve quality of life and mobility.

Resources

Levy, M., & Wiersema, M. (2012). Endoscopic ultrasound-guided celiac plexus and ganglia interventions. Retrieved from UpToDate.

Mercandante, S., & Nicosia, F. (1998). Celiac plexus block: a reappraisal. Regional Anesthesia Pain Medicine, 37-48.
Yan, B., et al. (2007). Neurolytic celiac plexus block for pain control in unresectable pancreatic cancer. American Journal of Gastroenterology, 37-48.