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Pain treatment Plexus Coeliacus Permanent Block

Pain in the upper abdomen can be treated by blocking the nerves to the brain by blocking the plexus coeliacus or the splanchnic nerves running deep inside the abdomen next to the aorta. You may need to spend the night at the hospital after the procedure. 

Important information

Please let us know if you are taking blood thinners. You may need to quit taking this medication several days before the procedure. Certain painkillers can affect blood coagulation. Please consult your physician about your painkillers. If you have any sensitivities to iodine, bandages, contrast agents, or anesthesia, please consult your pain specialist. X-radiation may harm an unborn child. If you are pregnant or suspect you may be, please let us know before the start of the treatment. 

More information

The procedure

We use a CT scan or X-ray to determine the exact location of the nerves. During a plexus coeliacus permanent block you will be positioned on your back, while a splanchnic nerve treatment requires you to lie on your stomach. 

Different treatment forms

After numbing the skin, your surgeon will place a needle near the nerve ganglion. We will use imaging to ensure that the right position has been found. Once the needle is in position, one of the following procedures will follow: 

  • A test block: your surgeon will administer a local anesthetic which will numb the plexus coeliacus or splanchnic nerves for up to 24 hours. This will help us measure the effects a permanent plexus coeliacus block will have without causing permanent effects;
  • A, alcohol neurolysis: a procedure involving phenol or alcohol administered through the needle, which will damage the nerves and block them from transmitting pain signals;
  • Burning (Radiofrequency Ablation - RFA) the nerves using electrodes which will heat up the nerves up to 80 degrees celsius for 4 minutes which will damage them and block them from transmitting pain signals. 

Effects

The effects of a neurolysis or RFA procedure can last for weeks or months. Most people will not need general anesthetics, although we can give you something to calm you down if you prefer. 

Observation

We will keep you for observation at a recovery ward. You will not have to spend the night at the hospital after a test block or RFA, although we recommend not driving or biking after the procedure. 

After a neurolysis, you will need to spend several hours laying down and stay at the hospital for one night for observation. After a consultation with the pain specialist or anesthesiologist the following morning, you will be able to go home. 

Results

Plexus coeliacus blocks often have excellent results. You can decrease your pain medication in consultation with your pain specialist. 

The effects of the block may diminish over time. If necessary, you can get another neurolysis or RFA procedure. 

Complications and side effects

Your abdominal pain may increase for a short time following the plexus coeliacus procedure. Some people experience back pain, or pain when breathing. 

Splanchnic nerve treatment may cause lung collapse. To prevent this, we will keep you at the hospital for observation. Both treatment can cause the following side effects:

Low blood pressure or diarrhea occurs in approximately 40% of patients due to the small nerves in the ganglion that regulate the widening of the blood vessels in the abdomen or the intestinal peristalsis. Low blood pressure tends to be resolved after several hours and rarely lasts until the following day.

Only 1 to 2% of patients experience serious complications such as chronic diarrhea, weakness, or nerve disorders of the legs.