A celiac plexus block is a procedure used to control pain in the abdominal region. During the procedure a long-acting local anesthetic is placed at the celiac plexus to block the transmission of pain from the abdomen. The celiac plexus block procedure is most frequently used in patients when other pain medications or other less invasive therapies are not effective.
What is the Celiac Plexus?
The celiac plexus is a culter of nerves and nerve fibers that lie in the middle of the abdomen in front of the aorta, just above the pancreas, and near the adrenal glands which sit on top of the kidneys. It is a relay station for the nerves that supply the abdominal contents from the lower esophagus to part of the colon. The nerve fibers surround the aorta and the arteries serving the intestines.
Irritation, compression or entrapment of these nerve bundles causing abdominal pain can be due to:
- Tumor invasion,
- Chronic inflammation,
- Chronic pancreatitis,
- Crohn’s disease,
- Pancreatic cancer.
The celiac plexus block:
- Assists in the identification of the origin of abdominal pain.
- Treats acute and/or chronic pancreatitis.
- Relieve intractable cancer pain from upper abdominal malignancies, such as, pancreatic, liver, or colon cancer
The procedure is done by the physician by placing a needle through the back under x-ray guidance, using contrast dye injected into the area of the nerves to ascertain proper needle placement. A local anesthetic is used to numb the skin before the needle is inserted.
When the physician has determined proper needle placement, he will inject a large volume of a long acting local anesthetic into the plexus. The patient should notice immediate pain relief, although sometimes response can be delayed for several hours.
If successful, a neurolytic nerve block or radiofrequency neurotomy can be done for longer pain relief lasting weeks or months.