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Professional Radiology and Outpatient Imaging Services

Celiac Plexus Block/Neurolysis

What is Celiac Plexus Nerve Block?

The celiac plexus, previously called the solar plexus, is a bundle of nerves located in the abdomen. Typically, these nerves control painful sensations and basic nerve functions from abdominal organs like the pancreas. However, certain conditions can cause them to carry pain signals from the abdominal organ tissues to the spinal cord and brain. A celiac plexus block provides relief from some of these painful sensations by injecting local anesthetic into or around the celiac plexus.

What Conditions are Treated With Celiac Plexus Blocks?

There are several conditions that can cause moderate to severe celiac plexus pain:

  • Chronic Pancreatitis
  • Pancreatic Cancer
  • Other abdomen cancers
  • Pain that doesn't respond to other pain treatments

How is Celiac Plexus Nerve Block Performed?

A nurse will start an IV if you are requesting sedation and take a preoperative nurse assessment. All patients are taken into a room with a CT Scanner. We will then administer moderate sedation to make you comfortable before the procedure begins.

A cold cleaning solution will be placed on your skin to help decrease chances of infection. The procedure site is then identified by your doctor under CT guidance. Once the site is identified, a shot of numbing medicine will be given to numb up the skin. This may feel like a bee sting, but will only last a few seconds. One or two small needles are then placed into the position using CT guidance. Dye is injected to confirm proper placement of the needle and the spread of medication around the celiac plexus.

Medication consisting of steroid and local anesthetics is injected through the needle. More permanent pain relief can be obtain by injection alcohol which is known as neurolysis. These medications spread around and bathe the nerves. The same procedure is sometimes repeated on the opposite side to insure all of the celiac plexus is covered. Most patients report profound pain relief quickly. The needle is then removed and you will be taken to the recovery room. The procedure itself takes 15-30 minutes and then you will be observed after the procedure. You may then go home and enjoy the rest of your day.

What are the Risks Associated with Celiac Plexus Blocks?

Celiac plexus blocks are considered an appropriate non surgical treatment for many patients who suffer from severe abdominal pain. The procedure itself is very safe and has been performed for decades. The risks are typically low, but can include misplacement of the needle, bleeding, infection, puncture of surrounding organs, puncture of adjacent vessels, drug allergy, nerve damage and/or paralysis. The most common side-effects related to the procedure are hypotension and transient diarrhea.

Post Procedure & Follow Up

You may notice an immediate “warm sensation” in your abdomen. You should also notice that your abdomen pain is substantially less or many times disappears completely. We tell most patients to take it easy the rest of the day, but you may return to normal activities as soon as you feel ready. The pain relief may last several days to several months. Some patients require repeat injections for long term pain relief. If the injection works well and takes away a substantial portion of your pain, but simply does not last very long, then you may be a candidate for neurolysis (nerve deadening) with alcohol. This procedure is repeated as above and is very safe and effective. It is a more long term (6 months or greater) solution if the simple bupivicaine and steroid does not provide long lasting relief.