Celiac Plexus Neurolysis
What is celiac plexus neurolysis?
Cancer affecting the stomach, liver, pancreas, gall bladder, intestines and liver cause excruciating pain in the abdomen. Chronic pancreatitis, which is a long-standing inflammatory disorder of the pancreas, also results in bouts of severe abdominal pain. Usually, powerful painkillers like morphine are used to treat the pain of these conditions. When morphine fails to provide adequate pain relief or has intolerable side effects, celiac plexus neurolysis is considered.
At Atlas Pain Care, Coimbatore, we target the celiac plexus – a bunch of nerves in your abdomen - to inject a chemical (usually absolute alcohol or phenol) to stop it. As a result of this, the nerves are unable to transmit the pain signals to the brain and results in pain relief for a period ranging from 3 to 6 months. If and when the pain returns, the procedure can be repeated.
What is celiac plexus?
Celiac plexus, also known as solar plexus, is a dense bunch of nerves situated in the abdomen, in front of the first lumbar vertebra and is responsible for carrying sensations, including pain, from the stomach, intestines, pancreas, gall bladder and liver. They receive pain sensations from these organs and act as a relay station to transmit the signals further up the spinal cord and from there to the brain.
What should I expect if I am undergoing celiac plexus neurolysis?
You will initially be assessed for fitness to undergo the procedure. If you are on blood thinning medications like warfarin or clopidogrel you will be given instructions on how and when to stop these medications before the procedure. You will be asked to come to our centre fasting for a period of six hours before the procedure. An anaesthetist will assess you before the procedure and you might require mild sedation during the procedure.
At Atlas Pain Care, Coimbatore, this procedure is done in a clean procedure room under X-ray guidance with you lying on your tummy. Local anaesthetic will be used to numb your skin in the back before the actual procedure needle is inserted. The tip of the needle is placed in the correct position using X-ray guidance and once the position is confirmed using a radioopaque dye, a local anaesthetic is injected close to the celiac plexus. When this produces immediate pain relief it will be followed by the injection of the actual chemical agent (alcohol, phenol). All your vital parameters like pulse rate, blood pressure and oxygen saturation will be continually monitored during the procedure. You will be shifted to the recovery room and observed for a period of at least 4-6 hours and discharged if deemed fit to do so.
How safe is this procedure?
Although a relatively straightforward and safe procedure, celiac plexus neurolysis does have a few short-term side effects. In our pain relief centre at Coimbatore, the common side effect is a drop in blood pressure soon after the injection, however this will be taken care by us by administering intravenous fluids. The other common adverse effect is diarrhoea for a few hours to days after the procedure. The diarrhoea is usually self-limiting and it is advisable to keep one well hydrated if it happens. Please read our FAQ section to know more about the do's and don'ts prior to and after the procedure.