What is a coeliac plexus block?
The term ‘coeliac plexus’ refers to a collection of nerves lying in front of your
spine. These nerves pass through the abdomen and supply nerve fibres
carrying pain and sensation to organs in the abdomen. A local anaesthetic is
injected around the area of the coeliac plexus nerves, through needles placed
in your back.
Why do I need a coeliac plexus block?
Coeliac plexus blocks can provide pain relief for certain conditions causing
chronic abdominal pain. The injection will not cure abdominal conditions or
pain, but may relieve some of your pain, giving you a rest from it and allowing
you to increase your general activity.
What happens on the day of treatment?
The procedure is carried out as an inpatient. You will be admitted to hospital
the day before you have the injection.
On the day of the procedure, you will be asked to put on a theatre gown and
your blood pressure, pulse, breathing rate and oxygen levels will be recorded.
Your Pain Consultant will then discuss the procedure with you and you will be
asked to sign a consent form.
The procedure itself is carried out in an operating theatre. This allows for the
injection to take place in a clean environment.
On entering the theatre, a small needle will be inserted into the back of your
hand. This allows the doctor to give you intravenous fluids and sedation or
emergency drugs if needed.
The injection is generally performed with you lying on your front on a table.
The doctor will clean your back with an antiseptic fluid, which can feel very
cold on the skin. An X-ray of your back will be taken to allow the doctor to
identify the specific site for the injection.
Local anaesthetic is then given into the back. This may sting initially, but the
area will soon go numb.
A needle is then inserted, under X-ray control, to the coeliac plexus. You may
feel a pushing sensation and some discomfort at this stage. If you do, you
should let the doctor know and more local anaesthetic can be given or you
can be given some sedation to relax you and make you feel sleepy.
Once the needle is in the correct position as seen on the X-ray, the local
anaesthetic is injected. A feeling of tightness may be felt. You should let the
doctor know if you feel any pain. The procedure usually takes around 1 hour.
Once the injection is completed, you will be taken to the recovery area within
the theatre suite where your blood pressure, pulse, breathing and oxygen
levels will be monitored for a short period of time. You will remain flat on the
bed for at least 4 hours.
The local anaesthetic may work for a short period of time to relieve some of
your pain. Coeliac plexus blocks provide each individual with varying degrees
of pain relief. Please take note of any short term improvement on the day of
treatment as this will guide future treatment.
It is important for you to move normally and carry out your usual activities to
see if the injection has been helpful.
You will need to stay in hospital overnight following the injection, but will be
able to go home the following day. You will be able to return to your usual
activities on this day.
Potential complications of coeliac plexus blocks
Some people experience tenderness or bruising where the injection was
performed. This usually settles over the next week or so.
The local anaesthetic may spread to the nerves carrying instructions to the
muscles in your legs and the nerves controlling your blood pressure. This may
cause your legs to temporarily become clumsy, weak or numb and your blood
pressure may drop, making you feel faint. If this happens, your blood pressure
will be monitored more closely, but it is temporary and will pass.
With any type of injection there is a risk of infection. Over the next few days
you should observe if the area around the injection becomes painful and
swollen, red, hot to touch or ‘weepy’.
Very rarely during the injection, the needle may pass through part of your lung
or your kidney. If this happens, you may feel breathless and your breathing
will be monitored more closely and you will be given some oxygen to help
your breathing. You may notice a small amount of blood in your urine, but this
is temporary and will resolve.
The local anaesthetic may also rarely affect the nerves controlling your bowel
and you may experience some diarrhoea after this injection. This again is
temporary and should resolve in 48 hours