Celiac Plexus Block

What is a celiac plexus block?

A celiac plexus block is a pain relief injection into a bundle of nerves, called the celiac plexus, in your upper abdomen. The treatment prevents these nerves from sending pain signals to your brain. It’s a type of nerve block.

Healthcare providers use celiac plexus blocks to treat conditions that can cause severe abdominal pain. You may need only one injection or several to manage pain.

What is the celiac plexus?

The celiac plexus is a group of nerves in your upper abdomen. It sits behind your pancreas and is close to your aorta (your largest blood vessel). It’s part of your nervous system.

Celiac plexus nerves send signals (communicate) to your brain and spinal cord from digestive system organs, including your:

• Gallbladder.
• Intestines.
• Liver.
• Pancreas.
• Stomach.

It can be painful when something presses against these nerves.

What does a celiac plexus block treat?

Healthcare providers use a celiac plexus block to ease chronic and severe abdominal pain caused by the following:

• Pancreatic cancer: Cancerous tumors can put pressure on your celiac plexus, causing pain.
• Pancreatitis: A celiac plexus block can alleviate severe upper abdominal pain or back pain caused by inflammation (swelling) of your pancreas.

Most people have significant abdominal pain at the time they receive a pancreatic cancer diagnosis. Healthcare providers typically prescribe strong pain medicines to manage this pain. But these medications can cause uncomfortable side effects like confusion, constipation and nausea. Even with medicine, you may still have pain. A celiac plexus block might help in these situations.

How should I prepare for a celiac plexus block?

Your healthcare provider will give you instructions to follow before a celiac plexus block. Your instructions may include:

• Stop taking certain medicines like blood thinners a few days before the procedure. Don’t make changes to your medications unless your provider approves it.
• Don’t eat or drink for several hours before the procedure. Anesthesia is safer on an empty stomach.
• Quit smoking, as tobacco products could increase the risk of complications.
• Arrange for someone to drive you to and from your appointment. A celiac plexus block is an outpatient procedure. You can go home the same day.

What happens during a celiac plexus block?

During a celiac plexus block, your provider will:

1. Give you a sedative medication through a needle in a vein in your arm (intravenously). This will help you relax, but you won’t be asleep.
2. Instruct you to lie on your stomach on a table with a pillow underneath your hips. If this is uncomfortable, your provider may position you to lie with your back on the table.
3. Sterilize (clean) the treatment area with an antiseptic.
4. Numb the treatment area with a local anesthetic injection. You may feel a slight pinch and pressure.
5. Insert a needle and inject a contrast dye into your abdominal region. The contrast dye shows up on an imaging scan like an X-ray, a CT scan or an endoscopic ultrasound. This helps your provider put the medication in the right place.
6. Inject a pain medicine (anesthetic) or steroid into the treatment area.
7. Inject alcohol or phenol into the celiac plexus (for a neurolytic procedure).

How long does a celiac plexus block take?

The entire celiac plexus block procedure usually takes about an hour. The actual injection is only a few minutes. You’ll need to get prepped before the injection and wait under observation for at least 30 minutes afterward. Your procedure time may be longer depending on the technique your provider used.

What happens after a celiac plexus block?

After a celiac plexus block, you may start feeling pain relief within 30 minutes. Your provider will have you wait at the treatment center under observation for at least 30 minutes to monitor you for complications. Within an hour or so, you’ll be able to go home. You’ll need to have someone drive you home.

What are the benefits of a celiac plexus block?

The benefits of a celiac plexus block include:

• Chronic and/or severe abdominal pain management.
• Decreases the frequency of breakthrough pain (periods of intense pain).
• Lessens the dosage or amount of oral (taken by mouth) pain medications you need.

What are the side effects of a celiac plexus block?

A celiac plexus block rarely causes complications, but side effects are possible. They may include:

• Bruising, swelling or soreness at the injection site.
• Infection at the treatment site.
• Diarrhea.
• Low blood pressure.
• Muscle spasms.

While rare, serious complications may include:

• Allergic reaction to anesthesia or the contrast dye.
• Decreased blood flow to your spinal cord.
• Delayed emptying of stomach contents (gastroparesis).
• Kidney damage or other organ damage.
• Nerve damage.
• Paralysis due to a spinal cord injury.
• Seizures.

Your provider will go over these possible side effects with you before the procedure so you’re informed about them and can make a decision about your care.

What does recovery look like after a celiac plexus block?

You should be able to go back to your regular activities within 24 to 48 hours after a celiac plexus block. You shouldn’t drive or do any strenuous exercise or lifting for the first 24 hours. You can also resume eating and drinking regularly after the procedure.

If you stop taking medications before treatment, your provider will let you know when it’s safe to start taking those again. It’s usually OK after the procedure.

How long does a celiac plexus block last?

The length of time you’ll feel pain relief after a celiac plexus block varies from person to person. Your provider will let you know what you can expect based on the type of medication they inject into your celiac plexus. For example, many providers inject a combination of an anesthetic and a steroid medication during a block. This may provide three to six months of pain relief. You may need another treatment in the future.

For longer-term relief, your provider may perform a neurolytic celiac plexus block. This technique destroys part of the nerves that send pain signals to your brain. You generally won’t need another treatment if you undergo a neurolytic block.

When should I call my healthcare provider?

You should call your healthcare provider if you experience the following after a celiac plexus block:

• Dizziness, fainting, unusual thirst (dehydration) or other signs of low blood pressure.
• Shortness of breath.
• Signs of infection, such as fever, or oozing and redness at the treatment site.
• Tingling, numbness or loss of feeling in your legs.