Celiac Plexus Block

What is a celiac plexus block?

A celiac plexus block is an image guided injection that can potentially help with abdominal pain. It is an injection of local anesthetic (numbing medicine) into or around a group of nerves (called the celiac plexus) that surrounds the aorta, the main artery in the abdomen.

What is the purpose of a celiac plexus block?

A celiac plexus block is performed to help alleviate pain that may be generated by organs in the abdomen, like the intestines or pancreas.

How long does the celiac plexus block take?

A Celiac Plexus block is a procedure that takes from 10 to 30 minutes.

What is actually injected?

Typically, a local anesthetic alone is injected. On certain occasions, epinephrine, clonidine or a steroid may be added to strengthen or prolong the effects of the block.

Will the celiac block hurt?

The procedure involves inserting a needle through skin and deeper tissues. So, there is some pain involved. However, to decrease your discomfort, we typically numb the skin and deeper tissues with a local anesthetic before beginning the procedure. If you are a safe candidate, we also offer intravenous sedation to help you tolerate the procedure.

Will I be “put out” for the celiac plexus block?

No. This procedure is done under local anesthesia with mild intravenous sedation. Some patients, however, may experience complete or partial amnesia of the procedure.

How is the celiac plexus block performed?

Our patients are lying on their belly and have basic monitors attached, such as an EKG, blood pressure cuff and an oxygen-monitoring device. We then clean your back and prepare the injection site to be performed under sterile conditions. The skin is numbed up with numbing medicine. Then an X-ray is used to to guide our needle into proper position. Once in the appropriate location, we inject a small test dose of dye, which is used to confirm that our needle is in precise location. Once confirmed, the celiac plexus block is performed gradually over the next several minutes under sterile conditions, again using X-ray guidance to evaluate the spread of the medication. When done, the needle is removed and a Band Aid is applied.

What should I expect after the celiac plexus block?

Immediately after the injection, your abdomen may feel warm and your abdominal pain may subside significantly. As a common side effect of the celiac plexus block, you may also notice weakness or numbness in your abdominal muscles and sometimes your legs as well.

What should I do after the celiac plexus block?

On the day of your celiac plexus block, please have a designated driver to take you home. You will take it easy and rest for the remainder of the day. We recommend you only perform light activities that you can tolerate. After a day or so, you may increase your activity level slowly.

Can I go to work to work the next day?

Unless there are complications or difficulties, most patients are able to return to work the following day. The most common issue after a celiac plexus block is soreness at the site of injection.

How long does the effect of the medication last?

It depends. The local anesthetic effect wears off in 1-3 hours. However, neural blockade of the celiac plexus could last for several more hours or even days. The duration of relief often gets longer and longer after each injection.

How many celiac plexus blocks do I need to have?

If you have significant benefit from the first injection, repeat injections will likely be recommended. It is often necessary to complete a series of injections to achieve longer term relief. Some patients require only 2 to 4 injections while others may need more than 10. Pain relief from the injections varies from patient to patient and determines the treatment pathway.

Will the celiac plexus block help me?

It is challenging to predict a patient’s response to a celiac plexus block. However, patients who are proactive and present early during their illness tend to respond better than those who allowed their symptoms to linger for a longer time span. Patients who have more advanced stages of disease may not respond at all.

What are the risks and side effects of a celiac plexus block?

Overall, this procedure is safe. However, with all procedure there are basic risks, side effects and a possibility of complications. The most common side effect is pain at the injection site. On rare occasion, other risks involve bleeding and infection. And on very rare occasion, risks include spinal block, epidural block, injection into a blood vessel or other organs or lung collapse. Again serious side effects and complications are fortunately very rare..

Who should not have a celiac plexus block?

Prior to your procedure, we will determine if you are a candidate for a celiac plexus block. There are some instances where you may not be a candidate for this procedure. If you have a history of an allergic reaction to any of the medications we would be injecting, you may not be a good candidate. If you are on blood thinning medications or if you have an active infection going on, or have unstable disease like poorly controlled diabetes of heart function, you may be at increased risk for a complication and we may consider postponing or cancelling your procedure.

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