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FAQs on Splanchnic, Celiac, Superior Hypogastric or Sympathetic Chain Block in Phoenix, Arizona

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The celiac plexus block, as well as the splanchnic nerve block, superior hypogastric nerve block, and sympathetic chain block, can be used for abdominal and lower pelvis pain. The pain of the abdominal and pelvic regions is often caused by entrapment, compression, or irritation of nerve bundles.

What conditions can cause abdominal or pelvic pain?

The pain of the abdominal region and/or pelvic area is often related to fibrosis, tumor invasion, chronic inflammation, chronic pancreatitis, Crohn’s disease, and bowel disease.

What are the nerves that supply the abdomen?

The sympathetic nerves that supply the abdominal organs are the celiac plexus and splanchnic nerves, which are dense clusters of nerve cells located behind the stomach, and near the diaphragm. Nerve signals to the abdominal organs often flow through these nerves. Organs supplied include the pancreas, stomach, gallbladder, small intestine, liver, and some of the colon.

What nerves supply the pelvic region?

The hypogastric plexus is a cluster of sympathetic nerves, which are involved in the function of the pelvic organs. These organs include the vagina, urethra, bladder, uterus, vulva, prostate, perineum, penis, testes, descending colon, and rectum. The superior hypogastric plexus sits just in front of the vertebral column, at around the level of the fifth vertebra region.

How do these abdominal and pelvic blocks work?

The celiac plexus block, splanchnic nerve block, superior hypogastric block, and sympathetic chain block are performed to diagnose and reduce abdominal pain caused by cancer or pancreatitis. By blocking these nerve bundles, pain signals cannot be transmitted from organs to the brain. The neurolytic block involves destroying nerves using alcohol or phenol. A local anesthetic and steroid are sometimes administered in addition to the neurolytic agent. The doctor uses fluoroscopy (real-time x-ray) to assure correct needle placement for injecting the solution.

How is a hypogastric block performed?

For the superior hypogastric plexus block, the patient is positioned on his/her stomach. The lower back region is cleaned using an antiseptic. After the skin and deeper tissues are numbed with a local anesthetic, the procedure needle is inserted and positioned near the nerves. Contrast dye may be used to confirm position of the needle.

superior-hypogastric-plexus-block

What is the purpose of the sympathetic nerve block for the upper thoracic regions?

For the upper abdomen, a sympathetic nerve block is used to offer complete pain relief. After the doctor determines that the block works, he/she can destroy the nerves for long-term pain relief. Regardless of the outcome, sympathetic nerve blockage is useful for many causes of upper abdominal pain.

What is the splanchnic nerve block?

Splanchnic nerves are located on both sides of the spine. These nerves carry pain information to the brain from abdomen organs. Blocking the nerves relieves and stops abdominal pain. With the splanchnic nerve block, the doctor inserts the procedure into the back using fluoroscopy guidance.

Do abdominal and pelvic nerve blocks work?

According to a recent study, patients with upper abdominal malignancy, who did not respond to opioids, had significant improvement with the celiac plexus block. Visual analog scores were improved after 24 hours and 3 months following the block. In another study involving patients with pancreatic cancer pain, researchers found that splanchnic nerve blocks lasted for 6 months, with consumption of opioids reduce. In addition, the study participants enjoyed lower pain scores and improved quality of life with no complications occurring from the procedure.

Resources

Anjughai HK, Karwasra RK, Kad N, et al. (2012). Ultrasound guided celiac plexus neurolysis by anterior approach for pain management in upper abdominal malignancy: Our experience. Anesthesia, Pain, and Int Care.

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