The celiac plexus is a cluster of nerves that lies in front and on the side of the aorta in the upper abdomen. It is a portion of the sympathetic nervous system that plays a role in the sensation and control of the abdominal organs. A celiac plexus block may be used to control sympathetically mediated pain in the abdomen from various chronic (and acute) conditions.

Prior to the procedure an intravenous line (IV) will be started and you will be placed on a monitor that will check your blood pressure and heart rate. You will be asked to lie on your stomach supported by pillows. A nurse will give you some sedating medication through your IV and will monitor you throughout the procedure. You will not be totally asleep for the procedure. You should experience reduced anxiety and pain with partial or total amnesia.

A radiology technologist will use an X-ray machine to locate the exact areas targeted for the procedure. Your back will be cleaned with a special solution and draped with sterile drapes. You will feel a burning sensation for 10-15 seconds as the doctor numbs the area with local anesthetic. You will then feel a pressure sensation and moderate discomfort as the doctor inserts the needle into the correct location. Once the needle is in the correct position, the doctor will inject a mixture of local anesthetic. The medication is injected near nerves providing loss of sensation to the area of pain.

Once the procedure is over, you will be taken to the recovery room and asked to lie down for 30 minutes before preparing to go home.

• The procedure may not help your pain.
• Small risk that your pain will become worse or result in residual pain.
• You may experience bruising at the injection sites.
• You may experience backache or muscle spasm for 24-48 hours following the block.
• The celiac plexus lies close to the large blood vessels in the abdomen. There is a small risk of puncturing one of these blood vessels and causing bleeding, which might require surgery to repair.
• The celiac plexus also lies close to the bowel and kidneys, and there is a small risk of perforating bowel which might cause an abdominal infection or injury to the kidney and require surgery to repair.
• The base of the lung is close to the celiac plexus. Although very rare, perforation of the lung is possible and may require chest tube placement or surgical repair.
• Perforation of cysts or tumors if a malignancy is present.
• In rare instances, damage to spinal nerves or the spinal cord resulting in paralysis or partial muscle weakness or persistent numbness.
• Rarely, reactions to the anesthetic drugs can cause flushing, ringing in your ears, or in very rare instances, seizures or respiratory depression.
• Allergic reactions to medications may cause your heart and breathing to stop or cause death.

• You may feel increased warmth of the abdomen.
• You may feel some temporary numbness or tingling.
• It is not uncommon to see a drop in blood pressure after this block.
• You may experience some backache or muscle spasms for the first 24-48 hours.
• Men may experience temporary impotence or failure of ejaculation for 12-24 hours.
• Temporary diarrhea may occur.
• If after a few hours of leaving the Center, any of these symptoms continue to worsen, please call The Pain Treatment Center or the on-call doctor.

It is not possible to predict to what extent, if any, celiac plexus will relieve your pain. However, this block is known to produce dramatic relief in some patients suffering from sympathetically mediated pain. In many individuals, pain will return gradually. When this occurs, the block may be repeated, or radiofrequency lesioning of the plexus may be considered. Your doctor may also recommend that you schedule an appointment with our Behavioral Medicine doctors to discuss stress management techniques. You may also be asked to stop smoking.