FAQS on Splanchnic Nerve Block

Abdominal pain occurs in relation to cancer, chronic conditions, and serious medical disorders. The splanchnic nerve block is used for chronic abdominal pain.

What types of pain respond to the splanchnic nerve block?

  • Cancer –The discomfort associated with abdominal and organ cancer can be treated with this block.
  • Chronic abdominal pain (CAP) – Also called functional abdominal pain syndrome (FAPS), this abdominal pain persists longer than six months.
  • Chronic pancreatitis – Causes severe abdominal pain.
  • Chronic cirrhosis – Liver disease that causes discomfort.
  • Chronic gallbladder disease – Abdominal pain that often radiates to the back, shoulder, and neck.

What are the splanchnic nerves?

The spine has three sections: cervical (neck), thoracic (mid-back), and lumbar (low back). The splanchnic nerves originate from the 11th and 12th vertebrae (spine bones), and extend down each side of the spine. These nerves relay motor and sensory information from the abdomen to the spine and brain. A block stops these signals of pain.

How do I prepare for a splanchnic nerve block?

Before the procedure, be sure to notify the doctor of all your health problems, as well as which medications you take. Certain blood-thinners must be held for several days prior to the procedure. This block is done using sedation, so arrange to have someone drive you home. When you arrive at the surgical center, a nurse will go over the pros and cons of the block, and you must sign a form of informed consent. After you change into a procedure gown, the nurse places an intravenous catheter in your arm.

How is the splanchnic nerve block performed?

The splanchnic nerve block is used to treat neuropathic pain originating from the abdominal region. The most popular method is the posterior approach, which involves positioning the patient face-down. The back region is cleaned with an antiseptic solution, and a procedure needle is guided near the nerves using x-ray guidance. To assure needle placement, contrast dye is injected. After medications are injected (antiseptic, neurolytic agent, and/or corticosteroid), the needle is removed.

How long does the procedure take?

The splanchnic nerve block takes around 30 minutes to perform. Many people report immediate relief after the injection, but it can take up to 2 weeks to enjoy the full effects.

What can I expect following the splanchnic nerve block?

After the procedure, a nurse will monitor you for around 30 minutes. Expect to have some tenderness at the injection site, and many patients report numbness and tingling down one or more extremities (legs/arms). Symptoms of nausea, dizziness, and drowsiness will resolve after a few hours. Do not bathe or soak in a tub for 1-2 days, and you should rest for at least 24 hours. Gradually return to activities as tolerated.

What risks and side effects are associated with this block?

A few patients experience a drop in blood pressure, but this resolves quickly. Risks are rare but include bruising, infection, bleeding at the injection site, minor injection site pain, and nerve damage.

Does the splanchnic nerve block work?

According to clinical studies, this block has around a 75% efficacy rate. In one study, patients who had the block used less pain medications and showed significant improvement.

Resources

Baghdadi S, Abbas MH, Albouz F, Ammori BJ. Systematic review of the role of thorascopic splanchnicectomy in palliating the pain of patients with chronic pancreatitis. Surg Endosc. 2008;22(3):580-8.

Loukas M, Klaassen Z, Merbs W, Tubbs RS, Gielecki J, Zurada A. A review of the thoracic splanchnic nerves and celiac ganglia. Clin Anat. 2010;23(5):512-22.

Saltzburg D, Foley KM. Management of pain in pancreatic cancer. Surg Clin North Am. 1989;69(3):629-649.

Suleyman ON, Tulu GK, Camlica H, & Erdine S (2004). Efficacy of coeliac plexus and splanchnic nerve blockades in body and tail located pancreatic cancer pain. European Journal of Pain, 8(6), 539-545.