The celiac plexus is a web of nerves that lies in the abdomen near the aorta. It is a relay station for the nerves that innervate the abdominal contents from the lower esophagus to part of the colon.
A celiac plexus block is a procedure in which 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. This type of pain may be caused by irritation, compression or entrapment of the nerve bundles because of tumor invasion, fibrosis, or chronic inflammation resulting from chronic pancreatitis or Crohn’s disease, among others. In particular, pain attributed to pancreatic cancer responds very well to a celiac plexus blockade.
The splanchnic nerves connect from the spinal cord to the celiac plexus and can be blocked using a local anesthetic. The splanchnic nerves lie close to the side of the spine. These are individual nerves; not a diffuse plexus. It is possible to lesion (therapeutically burn) the splanchnic nerves with energy generated using radiofrequency.
A celiac plexus block procedure involves the use of fluoroscopic x-ray imaging (real time x-ray) for precise needle placement and injection of a long-acting analgesic block to manage pain. Celiac plexus blocks typically provide temporary relief with less risk. Longer pain relief can be obtained with a neurolytic agent. The celiac plexus block procedure takes less than 30 minutes.
Another option for abdominal pain control is spinal cord stimulation.
If you are interested in learning about a celiac plexus block to manage your abdominal pain, please contact our pain management experts at The Spine and Pain Institute of New York in Manhattan, New York and Staten Island, New York. We would be happy to make an appointment for a consultation and provide additional information about other treatment options.