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腹腔神经丛阻滞常见问题解答

那里有很多关于腹腔神经丛阻滞的错误信息，这个页面应该有助于解决这个问题。此页面基于医学期刊、研究和研究。

什么是腹腔神经丛？

腹腔神经丛是一束与腹腔神经节相连的神经。这个神经簇服务于肝脏、胰腺、胆囊、胃、脾脏、肾脏和肠道。 

什么是腹腔神经丛阻滞（Celiac Nerve Block）？ 

神经阻滞是将药物直接注射到腹腔神经丛中。鸡尾酒通常包括麻醉药、类固醇和消炎药。每个医生都有他们自己使用的鸡尾酒，所以你的块会根据你看到的人而有所不同。

腹腔神经丛阻滞有什么作用？

该程序的目的是阻止您的神经向腹部的一部分发送疼痛信号。这个块纯粹是为了消除痛苦。它并非旨在消除恶心、呕吐、腹泻或便秘。有些人发现他们的其他胃肠道症状在使用阻滞剂后确实会减轻或消失，但这并不是阻滞剂设计的目的。

腹腔神经丛阻滞手术是如何完成的？

有两种方法可以进行腹腔神经丛阻滞；一种是从后面，这是最受欢迎的方式。另一种是使用一个范围进入你的喉咙并使用超声波探头将它们引导到你的神经丛中以注射药物。 

在背部腹腔神经丛阻滞期间会发生什么？

平均而言，您会服用药物来帮助您放松，并且您会接受暮光镇静。暮光镇静会让你忘记事件本身，但这是在你被镇静时发生的事情。疼痛专家会麻醉您背部的皮肤。然后他们将使用 X 射线成像将细针插入脊柱两侧的背部。他们会注射染料以确保将您直接刺入您的腹腔神经丛。一旦找到神经丛，他们就会注射止痛药以阻止神经将疼痛信号传递到您的腹部。手术后您可能会发现背部酸痛。

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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