Celiac Plexus Blocks and Splanchnic Nerve Blocks

Celiac plexus and splanchnic nerve blocks are effective treatments for chronic abdominal pain, most frequently that of which originates from abdominal malignancy. These comprise part of the rich innervation of the abdominal cavity, which mediate pain signals originating from intra-abdominal pathology. Nerve blocks for these structures are often accomplished using image-guided techniques, such as fluoroscopy, computed tomography (CT), or ultrasound. Multiple approaches to celiac plexus blockade are discussed, including anterior and posterior techniques. Local anesthetics can be utilized alone or in combination with neurolysis for longer lasting analgesia. Successful nerve blockade in these areas can result in fewer adverse effects when compared to opioid-based analgesics, which can be important in patients with intra-abdominal pathology. Side effects can include diarrhea, abdominal cramping, and orthostatic hypotension, which are generally transient.