Celiac Plexus Block

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Cancer patients have consistently reported that the pain associated with cancer is not surprisingly the single most distressing aspect. Further, pancreatic cancer is well documented to be one of the most painful malignancies, and this pain has been reported as often non-responsive to typical medication interventions, such as opioids.

The celiac plexus block is a non-surgical treatment option available for patients experiencing chronic abdominal pain. Indeed, the 
celiac plexus block has also been beneficial for relieving nerve pain in patients with pancreatic cancer.

The celiac plexus is a bundle of nerves located behind the stomach and in front of the diaphragm. It contains between one and five large ganglia that receive information from the abdomen and transfers this information to the spinal cord and brain. Thus, a celiac plexus block serves to prevent this information transfer and, thus, reduces or eliminates the patient’s experience of abdominal pain.

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The celiac plexus block is minimally invasive, does not involve surgery, and is done using only local anaesthetic. This treatment includes anaesthetizing the celiac plexus nerves, thereby preventing or “blocking” the nerves from transmitting information about pain sensations to the spinal cord and brain.
There are several methods by which physicians are able to anaesthetize the celiac plexus bundle of nerves. The most common method requires the patient to be lying on their abdomen. A local anaesthetic is applied to two places on the surface of the skin on the patient’s back. Using an x-ray as a guide for proper placement into the celiac ganglia, the physician inserts two small needles on either side of the patient’s vertebrae. Contrast dye is used to test for proper placement of the needle prior to injecting the anaesthetic, as well as appropriate distribution of the solution within the area. Once proper placement has been assured, the physician administers the anaesthetic.

In a neurolytic celiac plexus block, alcohol along with a numbing agent is used to destroy the nerves that carry pain information, rather than simply impairing their functioning temporarily. Thus, the alcohol destroys the celiac ganglia, preventing them from transmitting information about pain sensations within the nerves of the abdomen to the spinal cord and brain.
The procedure takes approximately 30 minutes to complete and significant reductions in pain are experienced almost immediately. The patient is then moved to a recovery room and is monitored for adverse reactions for anywhere between two to four hours.
Patients are expected to feel relief from pain following a celiac plexus block within approximately six to 24 hours. A series of procedures is typically recommended as a treatment for pain. If a patient experiences relief from pain symptoms following a celiac plexus block, then it is recommended that they have repeat injections until they are no longer experiencing abdominal pain. Generally, patients can expect the duration of pain relief following the procedure to increase following each administration. Patients can expect to experience approximately two months of pain relief from the neurolytic celiac plexus block.

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The celiac plexus block has been documented as most effective in reducing or relieving abdominal pain that is characterized by a strong nerve, or visceral, component. In particular, patients suffering from chronic abdominal nerve pain are ideal candidates for celiac plexus blocking. Individuals with pancreatic cancer have also been reported as having responded well to this pain management option, as well as patients suffering from malignancies of the liver, gallbladder, stomach, or large colon owing to the locality of the condition.

Neurolytic blocks are less common and typically reserved for treating pain associated with malignancies of the upper abdomen, particularly pain that has been unresponsive to opioids. Nonetheless, neurolytic blocks have been utilized in treating chronic abdominal pain associated with non-malignant conditions.

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The celiac plexus block is a minimally invasive, non-surgical treatment option for individuals suffering from abdominal nerve pain. This treatment option is particularly helpful to those patients whose pain has largely been unresponsive to opioids treatment or who have exhausted other conservative treatment options. This procedure involves a relatively low risk and its pain-relieving effects can be experienced immediately. For individuals whose pain does not respond right away to the intervention, effects can be felt following a few repeat interventions.