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Preguntas frecuentes sobre el bloqueo del plexo celíaco

Hay mucha información errónea sobre el bloqueo del plexo celíaco y se supone que esta página ayudará con eso. Esta página está basada en revistas médicas, investigaciones y estudios.

¿Qué es el Plexo Celíaco?

El plexo celíaco es un conjunto de nervios conectados a los ganglios celíacos. Este grupo de nervios sirve al hígado, páncreas, vesícula biliar, estómago, bazo, riñones e intestinos. 

¿Qué es un bloqueo del plexo celíaco (bloqueo del nervio celíaco)? 

El bloqueo nervioso es una inyección de medicamento que se coloca directamente en el plexo celíaco. El cóctel generalmente incluye medicamentos anestésicos, esteroides y un antiinflamatorio. Cada médico tiene su propio cóctel que usa, por lo que su bloque será diferente según a quién vea.

¿Qué hace el Bloqueo del Plexo Celíaco?

El objetivo del procedimiento es bloquear los nervios para que no envíen señales de dolor a una parte de su abdomen. Este bloque es puramente para eliminar el dolor. No está diseñado para eliminar las náuseas, los vómitos, la diarrea o el estreñimiento. Algunas personas han descubierto que sus otros síntomas gastrointestinales disminuyen o desaparecen después de tener el bloqueo, pero no es para eso que el bloqueo está diseñado.

¿Cómo se realiza el procedimiento de Bloqueo del Plexo Celíaco?

Hay dos formas de hacer un bloqueo del plexo celíaco; uno es desde atrás, que es la forma más popular. La otra es usar un endoscopio que baja por su garganta y usar una sonda de ultrasonido para guiarlos hacia su plexo para inyectar el medicamento. 

¿Qué sucede durante un bloqueo del plexo celíaco por la espalda?

En promedio, se le administran medicamentos para ayudarlo a relajarse y recibe una sedación crepuscular. La sedación crepuscular te hará olvidar el evento en sí, pero esto es lo que sucede mientras estás sedado. Un especialista en dolor adormecerá la piel de su espalda. Luego, usarán imágenes de rayos X para insertar agujas delgadas en la espalda a ambos lados de la columna. Te inyectarán un tinte para asegurarse de que te peguen directamente en el plexo celíaco. Una vez que encuentran el plexo, inyectan el analgésico para impedir que los nervios transmitan señales de dolor a su abdomen. Es posible que tenga dolor de espalda después del procedimiento.

What is done during a Celiac Plexus Block Endoscopically?

This procedure uses a scope that goes down your throat and uses an ultrasound probe to guide them into your plexus to inject the medication. This procedure typically takes 15 - 20 minutes. 

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Steps for procedure:

  • The patient receives an IV and goes under sedation

  • Locating the aorta and tracing it to the celiac trunk 

  • Passing a needle through the scope into the celiac area 

  • Injecting medication

  • Flushing the needle with saline 

  • Retracting the needle and removing the scope

Are there different types of medications used for Celiac Plexus Block?

Yes, different types of medications can be used for CPBs. These can affect how long your blocks last and how the block itself works. If you have any reactions to the following medications, you should bring them up with your provider. In most cases, alternatives can be used.​

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Medication Types:

  • Local anesthetics: Such as ropivacaine or bupivacaine 

  • Corticosteroids: Such as dexamethasone or methylprednisolone 

  • Adjuncts: Such as clonidine or epinephrine 

  • Neurolytic: Such as phenol or ethanol

What’s the difference between a Celiac Plexus Block and a Neurolytic Celiac Plexus Block?

The most significant difference between the standard CPB and Neurolytic CPB is the time they last. Many find that the standard block doesn’t last as long as they need it to. So, they get a block with a neurolytic agent.

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Celiac Plexus Block

CPBs can last from a few hours to a few months. This range depends on the type of medication used and how the patient's body processes the medication.

Neurolytic Plexus Block

Neurolytic CPBs are considered a longer-term pain relief version of the CPB. They usually last anywhere from 6 months to a year. This range depends on the type of medication used and how the patient's body metabolism processes the medication. 

Can a Celiac Plexus Block be done without sedation?

A Percutaneous CPB can be done without sedation. However, some doctors still provide a local numbing agent before the procedure. If this is your first experience with nerve blocks, it isn’t recommended to do it this way.

How will I feel after the block?

If you have had a positive response to the block, you should feel some relief from your MALS pain. It varies from person to person for how long this will last. You have to keep in mind that this is supposed to be temporary. It's treating the symptoms of MALS; it's not going to fix it.

Are there negative side effects to a block?

Yes, just like any other medication, there is a risk of negative side effects. The most common responses are diarrhea and a decrease in blood pressure. So, if you have low blood pressure, normally, that is something to discuss with your doctor before undergoing the procedure.​

​Side Effects Include:

  • Bruising, swelling, or soreness at the injection site

  • Infection at the treatment site

  • Diarrhea

  • Low blood pressure

  • Muscle spasms

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Rare Side Effects:​

  • Allergic reaction to anesthesia or the contrast dye

  • Decreased blood flow to your spinal cord

  • Delayed emptying of stomach contents

  • Kidney damage or other organ damage

  • Nerve damage

  • Paralysis due to a spinal cord injury

  • Seizures

If you experience any of the following symptoms, you should call the doctor who performed your block.

  • Dizziness

  • Fainting

  • Unusual Thirst (Dehydration) 

  • Shortness of Breath.

  • Signs of Infection (Fever, Oozing, and Redness at the Treatment Site)

  • Tingling, Numbness, or Loss of Feeling in your Legs.

How long does the average Celiac Plexus Block Last?

The average CPB lasts from a few weeks to several months, depending on the medications used and the patient's metabolism.

Can I have no response or a negative response to the Celiac Plexus Block and still have MALS?

Yes, just like any other medication, there are times when a CPB does not work for a MALS patient. This can be due to a variety of factors. It is often more related to how the patient metabolizes nerve medication. Celiac Plexus Blocks are reported to be 70 - 85% effective for general GI Pain.

Are there other options for Nerve Blocks?

Absolutely, if you find that a CPB didn’t work for you or gave you too many side effects there are other blocks to try. The most popular being a Splanchic Nerve Block (SNB) or a Hypogastric Nerve Block (HGNB). Make sure to discuss all your options with your pain management team so you can find what works best for you.

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