Celiac plexus block

Celiac plexus block is a pain relief procedure used for patients with abdominal cancers, most commonly pancreatic cancer. It’s also known as celiac plexus neurolysis or CPN.

If you have abdominal cancer, your cancer care team may recommend a celiac plexus block to help control your pain. The procedure is an injection that damages the celiac nerves, a bundle of abdominal nerves located behind the pancreas. Its success stems from the fact that damaged nerves can no longer send messages of pain to your brain, so you’ll no longer feel discomfort from the cancer.

Why is celiac plexus block used?

A celiac plexus block is used because it’s a powerful pain management tool. Due to the location of the pancreas, a pancreatic cancer tumor often presses on other nearby organs as it grows, causing many patients to experience severe pain in the:

• Stomach
• Back
• Abdominal area

While many doctors prescribe opioid-based pain medication for this discomfort, you may still feel breakthrough pain. Sometimes, the medication isn’t successful, or it can cause side effects, such as:

• Fatigue
• Dizziness
• Constipation
• Nausea
• Addiction

As an alternative to opioids, a celiac plexus block is a useful tool to manage pain without the side effects associated with opioids such as oxycodone or codeine.

How to prepare for your procedure

If you’re scheduled to undergo a celiac plexus block procedure, your care team can outline exactly how to prepare, including any limitations on eating or drinking beforehand.

It’s also a good idea to arrange for someone to drive you home after you’re discharged.

What to expect

While your doctor will let you know ahead of time which technique will be used, a celiac plexus block may be done in three ways:

• Via injection
• Surgically
• During an endoscopic ultrasound (EUS) 

During the procedure, you can expect to:

• Receive a local anesthetic to numb any pain
• Potentially have a dye injected to help guide the doctor, via an imaging scan, to the exact injection site for the medication
• Have alcohol injected into the celiac plexus, which damages the nerves so they can no longer send pain signals to the brain

The entire procedure takes about 30 to 60 minutes as outpatient surgery.

You may start feeling pain relief very shortly after it’s finished. After an observation period, you’re usually free to go home.

Your care team can provide you with clear aftercare instructions, so always follow their guidelines to maximize your recovery.

Benefits of celiac plexus block

Because a celiac plexus block injection is safe and well-tolerated with few side effects, it makes for a good alternative to daily pain medication. Once the procedure is complete, over the long term, you should have no pain or greatly reduced pain.

For some patients, this can completely eliminate the need to take pain medication.

How long does a celiac plexus block last?

The extent of long-term pain relief from a celiac plexus block varies by patient. In most cases, patients will get two to six months of pain relief after the procedure.

Celiac plexus block side effects

You may experience side effects after a CPN procedure. Some of the most common include:

• Discomfort, swelling or muscle spasms near the injection location
• Diarrhea
• Low blood pressure
• Infection
• Allergic reaction

More serious side effects—such as kidney damage and seizures—are less common, but still possible.

If you feel unwell after your procedure, contact your care team right away.

How will I know if my procedure was successful?

Usually, you’ll know immediately if your celiac plexus block was successful, because you’ll start to feel reduced pain. If you still feel pain after a CPN procedure, your doctor can help you manage your pain levels and discuss additional treatment options with you.

As always, your care team is there to help, so be sure to talk to them if you have any questions or concerns about pain throughout your cancer treatment.

If you're interested in hearing more about celiac plexus blocks, call us or chat online.