Celiac plexus nerve block

Neurolytic Block of the Celiac Plexus and Splanchnic Nerves... 

In tumors involving the lower third of the mediastinum, it is necessary to block the splanchnic nerves which contribute an important sensory nerve supply to the lower third of the intrathoracic part and the abdominal portion of the esophagus. The other indications are similar to those for celiac plexus block and splanchnic nerve block is preferred to celiac block in cases with large infiltration and invasion of periaortic space. The splanchnic nerve block requires a smaller volume of alcohol (Bonica 1990b Kurdziel and Dondelinger 1990 Herpels et al. 1988 Crespy et al. 1984 Lillemoe et al. 1993). 

With the use of celiac plexus or splanchnic nerve block, between 70% and 85% of patients with severe abdominal cancer pain obtained pain relief lasting from 1 month up to 1 year (Bonica 1990b). The most frequent complication with celiac plexus block is orthostatic arterial hypotension (Lema et al. 1992 Kurdziel and Dondelinger 1990 Schild 1998 Whitemann et al. 1986 Pateman et al. 1990 Lee et al. 1993 Herpels et al. 1988 Haaga et al. 1984 Fujita and Takaori 1987). 

In splanchnic nerve block, complications like orthostatic arterial hypotension are unusual because the procedure is less likely to involve the lumbar sympathetic chain than with celiac plexus block. Pneumothorax, intrathecal, and intravascular injection can be avoided under precise CT guidance (Kurdziel and Dondelinger 1990). 

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