Celiac plexus, or retrocrural splanchnic nerve blocks, which are effective for non-cancer abdominal pain

Non-cancerous abdominal pain was effectively treated with computed tomography (CT) -guided celiac plexus or retrocrural splanchnic nerve blocks (CP / RSN), according to the results of a retrospective review of clinical records published in Academic Radiology.

Patients (N = 72) who underwent CP / RSN blocks for abdominal pain between 2011 and 2020 at the Mayo Clinic in Arizona were evaluated for clinical results.

Patients had a mean age of 43 (range 19-78) years, 60% were women, 68% had type 2 diabetes, 74% had bilateral pain, 75% had temporary block, and 61% had celiac block.

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Most patients (n = 40) received CP / RSN blocks for non-cancer pain. All procedures were technically successful.

More than half of the patients (67%) had effective pain relief after their CP / RSN blockade, which lasted an average of 51 (range, 2-700) days. Of the 24 ineffective procedures, pain was relieved for an average of 1 (range, 0-8) day (s).

Stratified by celiac disease and splanchnic blocks, effective pain relief was achieved in postural orthostatic tachycardia syndrome or dysautonomia (67% and 82%), pancreatitis (86% and not applicable), chronic postoperative pain (67% and 50%), and median arch ligament syndrome (60%) or 80%).

Among the effective permanent blocks, pain relief lasted an average of 111 (range 14-390) days. More celiac permanent blocks were effective (62%) than splanchnic blocks (20%).

For the temporary blocks, 72% were effective with an average relief of 37 (range, 2-700) days. Fewer celiac blocks were effective (65%) than splanchnic blocks (83%).

In patients who had previously been blocked, fewer permanent interventions were effective (40%), but more temporary blocks (88%).

Side effects of CP / RSN blocks included diarrhea (13%), pain (4%), vomiting (4%), nausea (3%), and gas (3%). Chronic diarrhea lasted 4 and 6.5 months in 2 patients.

This study was limited by relying on patient-reported pain relief rather than using validated pain assessment tools.

The study’s authors concluded that CT-guided CP / RSN blocks were effective in managing pain in most patients with non-cancer abdominal pain.


Liou H, Kong MJ, Alzubaidi SJ, Knuttinen MG, Patel IJ, Kriegshauser JS. Single-center review of celiac plexus / retrocrural splanchnic nerve block in non-cancer pain. Acad Radiol. Published online April 8, 2021. doi: 10.1016 / j.acra.2021.03.005

This article originally appeared on Clinical Pain Advisor

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