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All About Celiac Plexus Block for Abdominal Pain

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The celiac plexus is a bundle of nerves positioned behind the stomach and in front of the diaphragm. The celiac plexus block involves injecting these nerves with an anesthetic agent to treat intractable pain from cancers and chronic abdominal problems.

This nerve block is used to relieve the pain associated with serious disorders of the abdominal region. The celiac plexus block is reserved for the treatment of severe, intractable pelvic or abdominal pain that does not respond to other treatments. This block is commonly used for pancreatic cancer and the management of chronic functional abdominal pain.

How do I prepare for the procedure?

  • Before the celiac plexus block, you should go over all your medications with the pain doctor in Beverly Hills. If you are taking a blood-thinning agent, the doctor will advise you on how many days you must hold it. When you arrive at the medical facility, a nurse will advise you of the procedure and have you sign an informed consent form. In addition, you need to bring someone to drive you home, in case sedation is used. The nurse will place an IV catheter in your arm and attach several monitoring devices to you to assess your vital signs.

How is the celiac plexus block performed?

  • The celiac plexus block is usually performed by the posterior approach. The Los Angeles pain management doctor will position you on your stomach, and cleanse your skin with an antiseptic solution. The skin and deeper tissues are injected with a local anesthetic before a needle is inserted to the side of the vertebrae (spine bones). Using x-ray guidance, the doctor injects a contrast solution to assure the needle is positioned near the celiac plexus nerves. The long-acting anesthetic is injected onto the nerves, or the doctor may use a neurolytic agent (phenol or alcohol) to destroy a portion of the nerve root. The procedure usually takes around 30 minutes.

What can I expect after the procedure?

  • After the celiac plexus block, you will be moved to a recovery area where a nurse will continue to monitor your vital signs (blood pressure, pulse, oxygen level). Expect to notice immediate relief of pain after the block, but soreness at the injection site could last for up to 24 hours.

What benefits are associated with the celiac plexus block?

  • The celiac plexus block prevents the transmission of pain signals to the brain, which interprets them as discomforting sensations. The block reduces reliance on pain medication and allows the patient to resume regular activities. The pain relief duration associated with this block varies from patient to patient. Many people enjoy months of pain relief following the celiac plexus block, whereas others only have a few weeks of comfort.

How effective is the celiac plexus block?

  • In a recent randomized, controlled trial, researchers found that half of the patients who received the block experienced complete symptom relief. In another study, celiac plexus neurolysis resulted in equal reduction in visual analog pain scores and lowered opioid consumption. In a meta-analysis of 21 studies, the success rate of celiac plexus block was found to be 90%.

What are the risks and complications associated with the celiac plexus block?

  • The celiac plexus block is a safe, non-surgical procedure for the treatment of severe abdominal pain. The risks are few and rarely occur. However, complications include bleeding, collapsed lung, infection, blood vessel damage, nerve injury, and organ damage. Intelligent Pain Solutions offers compassionate, highly skilled care for all types of pain conditions. This includes abdominal and pelvic pain. Both medication and interventional pain management is offered with a Double Board Certified, highly respected pain doctor in Beverly Hills and Los Angeles.
  • Most often, chronic abdominal pain syndrome (CAPS) occurs in cancer patients in the late stages of the disease, which significantly affects their quality of life. One of the first and main methods of treating BS is pharmacological. Elimination or alleviation of BS helps to reduce the dosage or stop taking narcotic painkillers in patients with abdominal tumors and chronic pancreatitis. The method is devoid of the main disadvantages inherent in the percutaneous method, which makes it possible to safely and effectively perform drug blockade or NL of the celiac plexus. The advantages of celiac plexus NL under the control of endoscopic ultrasonography (EUS-NL) compared to NL under ultrasound and CT control include: a) better visualization of the needle; b) better orientation (Doppler mapping) of the needle relative to the great vessels; c) execution with navigation and control in real time; d) insertion of a needle from the lumen of a hollow organ (stomach) adjacent to the area of interest along the shortest route. A meta-analysis conducted by E. Eisenberg assessed the effectiveness and safety of NL based on the results of publications in 49 articles reporting information on 1322 patients who underwent percutaneous NL. Excellent results were achieved in 75% of cases with full effect realized within the first 2 weeks; in 90% of patients who survived 4 months from the date of NL, the effect was partial, as well as in 73% of patients who died in the next 3-4 months.

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