What Is a Plexus Block?

A plexus block, also known as a celiac plexus block, is an injection that prevents celiac plexus nerves from sending pain messages to the brain. Celiac plexus nerves send signals to the brain and spinal cord from the digestive organs, including the gallbladder, intestines, liver, pancreas, and stomach. This plexus contains a bundle of nerves in the upper abdomen that sits behind the pancreas close to the aorta, the body’s largest blood vessel. A plexus block helps to relieve severe abdominal pain caused by pancreatic cancer or chronic pancreatitis. It can also be used to alleviate upper abdominal pain or back pain. 

Causes for a Plexus Block

Patients with pancreatic cancer or chronic pancreatitis are the main need for a plexus block. Cancerous tumors can put pressure on the celiac plexus, causing pain. A plexus block can help to manage the extreme abdominal pain associated with these conditions.

Often times, providers will prescribe medications to help manage this type of pain, but it can cause uncomfortable side effects, like confusion, constipation and nausea. A plexus block allows for less medication intake and less side effects. Your provider will discuss with you the pros and cons of this nerve block treatment.

How Does a Plexus Block Work?

Prior to your procedure, tell your provider about the medications you are taking, including blood-thinning medications and over-the-counter medications. Talk to your provider about any recent illness or other medical conditions. Do not eat or drink anything for a few hours before your procedure. Inform your provider if you are pregnant or have a possibility of being pregnant.

In the plexus block, your provider will use a fluoroscope to guide the needle into the correct space. A contrast dye will then be injected to ensure proper location. An anesthetic or steroid is then injected into the treatment area to numb the nerves. Then, alcohol will be injected into the plexus to damage the nerves, preventing pain signals from traveling to the brain. 

Although it’s rare, tell your provider immediately if you feel a sudden jolt of pain. This means the needle has come too close to the major nerve and needs to be repositioned.

What to Expect After a Plexus Block

Most people will experience pain relief within 15 to 30 minutes of getting the nerve block. It is normal to feel sore at the site of injection for a few days. Applying an ice pack and taking medication may help with swelling and pain. You should avoid strenuous activities and driving for at least 24 hours. As the numbing medication wears off, you may feel a slight increase in pain until the medication takes effect. Potential side effects may include:

• Bruising, swelling or soreness.
• Infection at injection site.
• Diarrhea.
• Low blood pressure.
• Muscle spasms.

Pain relief provided by a plexus nerve block will vary from person to person. Most people get 3 to 6 months of pain relief. If the block does successfully provide pain relief and the pain returns, your provider may recommend another procedure. A neurolytic celiac plexus block damages the nerves to provide long-term pain relief, so additional procedures are typically not needed.

Risks of a Plexus Block

Although problems caused by a plexus block are rare, every procedure has it risks. Complications may include:

• Allergic reaction to the dye or anesthetic.
• Decreased blood flow to the spinal cord.
• Delayed emptying of stomach contents.
• Kidney damage or other organ damage.
• Nerve damage.
• Paralysis due to spinal cord injury.
• Seizures.

Contact your healthcare provider immediately if you experience:

• Dizziness, fainting, dehydration, or signs of low blood pressure.
• Shortness of breath.
• Signs of infection.
• Tingling or numbness in the legs.