Celiac plexus block: 5 things to know about the procedure

Managing pain is an important part of cancer treatment. There are many pain management options, depending on the patient’s preferences and medical history.

If you have chronic abdominal pain and medications aren’t providing relief, outpatient procedures like a celiac plexus block may be helpful. Here are five things to know about the procedure.   

Celiac plexus block for abdominal pain relief

The celiac plexus is a group of nerves in front of the spine and behind the abdomen. These nerves connect the pancreas, gallbladder, intestines, liver and stomach to the nervous system. Patients may experience pain in these areas due to cancer growth. This pain may feel like dull cramping, squeezing, or a stabbing or sharp sensation.

A celiac plexus block is an option when other pain treatments, like anti-inflammatory drugs, nerve pain medications and even narcotics, are not easing your abdominal pain. A celiac plexus block can work in conjunction with your current pain medications, but it also offers a chance to stop taking them altogether.

The procedure disrupts the celiac plexus nerves in the abdomen, preventing them from sending pain signals to the brain. Think of it this way: Imagine your body is a house, and your abdomen is the living room with lights flashing on and off. The celiac plexus block is like going to the breaker box in the garage to fix the lights in the living room. Even though the breaker box is far from the living room, everything in the house is connected through it. Similarly, the block targets the nerves that send pain signals from your abdomen to your brain, stopping the “flashing lights” of pain.

What to expect during a celiac plexus block procedure

A celiac plexus block usually takes less than an hour. Your care team will set up an IV and ask you to lie on your stomach. If lying on your stomach is too painful, we can use pillows to support or position you on your side. Next, we clean your back with a sterilizing solution and place surgical drapes around the cleaned area. Using an X-ray machine, we take pictures of your spine to locate the celiac plexus located in your abdomen.

You’ll be awake during the procedure. We’ll numb the skin with a local anesthetic to make you comfortable. You might feel some pressure when we insert the needle on both sides of your spine. Once we inject the anesthetic, there is a brief waiting period to ensure it’s working.

After the anesthetic has settled, we’ll inject pain medicine into the same area to numb the celiac nerves. You might feel full or feel some pressure because this area is small and has limited space. This feeling will be temporary.

Once the procedure is complete, we’ll clean the injection site and apply Band-Aids. Then, we’ll move you to the post-recovery area for monitoring.

Recovery and aftercare following a celiac plexus block

Since the celiac plexus helps regulate blood pressure, you might experience a drop in blood pressure, causing symptoms like lightheadedness and dizziness. We’ll use IV fluids to keep you hydrated and help your body adjust. This usually takes 45 minutes to an hour. Once discharged, you can go home.

We ask patients to take it easy and avoid intense activities for the first 24 to 36 hours after the procedure. Whether you can continue chemotherapy and other treatments on the same day varies from patient to patient, so discuss this with your care team ahead of time. We always consult with the patient’s oncologist to ensure everyone is on the same page and to coordinate the timing of treatments.

Many patients notice a difference within the first 24 hours after the procedure. While every patient is different, you may even be able to reduce or stop taking your pain medications after a celiac plexus block.

Long-term pain management after a celiac plexus block

A celiac plexus block is not usually repeated. Some blocks are meant to be temporary, while others are meant to be permanent. Your doctor will explain the type of block you will have before your procedure. If pain returns, it signals to us that something in your body may have changed. We assess if it mirrors the previous pain before deciding to repeat the procedure or try a different treatment option.

Many patients are on both short-term and long-acting pain medications. We aim to help you simplify your medication regimen without abruptly stopping your meds. For example, if you take short-term pain medication every four hours, you might need it less frequently after the block. Over time, we can adjust long-acting medications accordingly.

Risks and side effects of a celiac plexus block

Your blood pressure may drop after the procedure, so fainting is a risk. It’s common to feel the need for a bowel movement or to pass gas after the procedure, but this is temporary.

Any time the skin is punctured, there is a risk of infection or bleeding. Since blood thinners can increase the risk of bleeding during a procedure, it’s important to consult with your care team about stopping this medication before the procedure.

Since the injection is near the spine, there are concerns about numbness and weakness. Because a local anesthetic is used to keep you comfortable, some numbness in the back is expected but should not be long-term.

While no procedure is risk-free, the risks associated with a celiac plexus block are uncommon. This procedure is routinely performed by MD Anderson pain medicine physicians to effectively manage patient pain so you can get back to living your life to the fullest.

Request an appointment at MD Anderson online or call 1-877-632-6789.