The celiac plexus is a bunch of nerves that supplies the sensation from organs in your abdomen (e.g., pancreas, bowel, etc.). In your case, your doctor feels as though this plexus may be transmitting pain signals that are causing you pain. The plexus is located along the side of your spine. Local anesthetic is injected if a diagnostic block is performed to help determine the source of your abdominal pain. Alcohol is injected to destroy the nerves when a neurolytic block is performed, usually for patients with cancer. A diagnostic block is often done prior to a neurolytic block to ensure that pain relief can be achieved by this type of injection. Your doctor will tell you if you are an appropriate candidate for a neurolytic block. Please note: This procedure cannot be performed if you have an active infection (and are on antibiotics), flu, fever, extremely high blood pressure, or if you are on blood thinners (e.g., aspirin, Coumadin, Plavix, Pletal). Blood thinners must be stopped five to seven days prior to the procedure. For your safety, please inform us if any of these conditions exists.
As with most procedures, there is a remote risk of bleeding, infection, nerve injury or allergic reactions to the medications we use. In addition, the injections may cause some soreness in your back, which can last up to one week. Using an ice pack should help. There is also a chance that the procedure will not relieve your pain. Immediately after the procedure your blood pressure may drop, so it will be monitored closely in the recovery room. Diarrhea may also occur immediately after the injection. With neurolytic blocks, there are additional risks-although remote-of paralysis, sexual dysfunction or a pins and needles sensation in your legs or groin.
After checking in and signing a consent form, you will have an IV placed, through which you will be given IV fluids prior to the procedure to minimize the drop in your blood pressure. In the procedure room, you will be positioned on your stomach. We will sedate you with medication in your IV to make you comfortable. Your back will be cleaned with a special solution. We will then use an X-ray (fluoroscope) machine to pinpoint the exact location of the celiac plexus as it relates to your spine and the needles we are using. The doctor will numb your skin, which will sting for a short moment. Usually one or two needles are used, one from each side of your body at most. The positioning of the needles is confirmed by injecting dye through them that we can see under the fluoroscope. Please tell us if you are allergic to contrast dyes. Once we confirm that that the needle(s) are in the correct location, the injection will be performed with local anesthetic, and then followed with alcohol if you are having a neurolytic block. Then, your skin will be cleansed and you will be taken to the recovery room. If a neurolytic block was performed, we may need to keep you lying facedown for up to 45 minutes. Your blood pressure will be closely monitored. You will be discharged home when you are stabilized and meet discharge criteria.
Following your procedure, you are not allowed to drive for the remainder of the day. An adult must be present to drive you home or to escort you on another form of transportation. This is for your own safety. In addition, do not go swimming or soak in a tub or Jacuzzi on the day of your procedure. Otherwise, you can do whatever you feel up to doing. Your pain may improve immediately after the injection, or it may take a few days if alcohol was used. You should take your normal pain medicines. The doctor will also give you a prescription for a short course of pain medicines, if needed following the procedure. If you were given a pain diary to record your pain scores afterward, please complete that and fax it back to us at 781-744-5624.
You should call us immediately at 781-744-5090 if you experience any of the following: