Cancer Pain – Celiac Plexus Block
Advanced, Clinical Subspecialties
Indications : Treatment of visceral abdominal pain (T5-T12) derived from sympathetic afferent nerves, often associated with abdominal cancers, especially pancreatic cancer. Occasionally to treat chronic pancreatitis.
How To Perform : Celiac plexus located at L1 on the anterolateral surface of the Aorta. Using fluoroscopy, typically performed with posterior entry point just below the level of the 12th rib.
Side Effects : Orthostatic Hypotension (most common), Diarrhea (2nd most common), Spinal/Epidural Injection, LAST, Perforation of Nearby Structures (Aortic/IVC/Visceral Organs), Retroperitoneal Hemorrhage, Pneumothorax, Chylothorax, Paraplegia
Burton, AW, Phan, et al. Treatment of cancer pain: Role of neural blockade and neuromodulation. In: Cousins and Bridenbaugh's Neural Blockade in Clinical Anesthesia and Pain Medicine, 4th, Lippincott, Williams & Wilkins, 2009. P.1122.