A celiac plexus block is a pain management procedure which blocks nerves in the abdomen. This procedure is carried out to treat chronic abdominal pain that occurs as a result of abdominal diseases such as chronic pancreatitis or pancreatic cancer. The celiac plexus block provides temporary pain relief that can last several days after the initial treatment. Generally, a course of several injections is given over time, and the duration of pain relief extends with each successive injection.
In this procedure, the celiac plexus nerves are blocked with an anesthetic injection. This nerve bundle surrounds the main abdominal artery, called the aorta. These nerves control certain basic bodily functions and transmit sensory information, including pain signals, from the abdominal organs and tissues to the brain. The organs that are fed by these nerves include the pancreas, gall bladder, liver, stomach and intestines.
Prior to having a celiac plexus block, a patient should ensure that he or she has transportation to and from the appointment. This is important because side effects of the procedure make it dangerous to drive immediately afterward. Someone undergoing this treatment also should ensure that his or her doctor is fully aware of all other medications being used, because some drugs can interfere with the anesthetic or increase the risks of the procedure.
During the procedure, the patient lies face down. He or she is generally monitored throughout the celiac plexus block with devices that measure blood pressure, heart activity and oxygen saturation levels. These devices provide a warning if any part of the procedure does not go as planned, because incorrect needle placement and injection of medications into a blood vessel or other area will result in immediate changes in blood pressure and other vital signs.
General anesthetic is not used during this procedure, but most patients are given local anesthetic to reduce the pain caused by the insertion of the block needle. Therefore, the first injection given is a local anesthetic. Next, the block needle is inserted. This typically is guided via X-ray images taken at certain points during insertion. After the needle has been confirmed to be in place at its proper location near the spine, the nerve block medication is administered.
A celiac plexus block has several potential side effects. Most of the common side effects are not dangerous but might be uncomfortable. Temporary low blood pressure, a feeling of warmth in the abdomen and tingling in the legs are common immediately after the procedure. Many people have mild back pain and watery bowel movements for a few days afterward. Rare complications include spinal nerve block, a collapsed lung or injury to blood vessels, nerves or kidneys.
