CELIAC/LUMBAR/HYPOGASTRIC PLEXUS OR SPLANCHNIC NERVE BLOCK

What is the celiac/lumbar/hypogastric plexus or splanchnic nerve and how is a block helpful?

The celiac/lumbar/hypogastric plexus and splanchnic nerves are groups of nerves that come together near the spine to supply the internal abdominal or pelvic organs. A block using local anesthetic can increase circulation and decrease pain. When circulation is increased, more oxygen and nourishment are brought to the area. The duration of pain relief form this local anesthetic can vary from 1-2 hours to many hours or sometimes even days. If your pain is relieved by this procedure, a series of blocks may be desired as an attempt to break the pain cycle.

General Pre-lnjection Instructions:

Be sure to tell Dr. Reginald Ajakwe and Dr. Raymond Tatevossian if you have an allergy, particularly to iodine. If you will be receiving sedation, you should NOT eat the morning of the procedure. If a patient is an insulin dependent diabetic and receiving sedation, they may need to change their morning dose of insulin to account for not eating the morning of the procedure. Patients may take their routine medications (i.e., high blood pressure and diabetic medications, e.g. Glucophage).

Patients should continue to take pain medications or anti-inflammatory medications the day of their procedure. If a patient is on Coumadin or another blood thinner, they should notify Dr. Reginald Ajakwe and Dr. Raymond Tatevossian so an appropriate plan can be made for stopping the medication before the procedure. Although not mandatory, we generally recommend that a driver should accompany the patient and be responsible for getting them home.

What happens during the procedure?

The patient is placed on the procedure table on their stomach so the physician can best visualize the spine using x-ray guidance. The plexus or nerve being blocked is located in relation to the spine. The skin is scrubbed using antibacterial soap. Next, the physician numbs a small area of skin with numbing medicine. This medicine stings for several seconds. After the numbing medicine has been given time to be effective, the physician directs a very small needle using x-ray guidance near the target area for the block. Then, a large volume of numbing medicine (local anesthetic) is injected.

What happens after the procedure?

After the procedure, the patient is taken to the recovery room. Patients are then asked to report the percentage of pain relief.

There may be some leg weakness, numbness, warmth in leg or legs, and back pain from needle insertion after the procedure. These effects are temporary, lasting only a few hours.

Patients may return to their normal activities on the day of the procedure. Driving is discouraged on the day of the procedure.

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