What is a Splanchnic Nerve Block?
Splanchnic Nerve Block Performed by Las Vegas, Summerlin, and Henderson Nevada’s Top Pain Doctors
The splanchnic nerve block is a non-surgical treatment option available for patients experiencing chronic abdominal pain. Studies suggest that cancer patients are most impacted by the pain associated with the condition. Cancer pain can be debilitating and has the potential for negative impacts on the patient’s attitude, mood, energy, and motivation to complete treatments. Furthermore, this pain is often non-responsive to typical interventions, such as opioids, leaving patients feeling hopeless.
The splanchnic nerve block is a non-surgical treatment option available for patients experiencing chronic abdominal pain. The splanchnic nerve block has been shown to be beneficial for reducing or relieving nerve pain in patients with pancreatic cancer, pancreatitis, and other conditions affecting the liver, gallbladder, pancreas, stomach, small intestines, and kidneys.
The splanchnic nerves are found on both sides of the spinal column. They begin at the eleventh and twelfth thoracic vertebrate and end in the abdomen at the celiac plexus. These nerves transmit information from the abdomen to the spinal cord and brain. Thus, the splanchnic nerve block serves to prevent this information transfer and reduce or eliminate the patient’s experience of abdominal pain.
How Is a Splanchnic Nerve Block Performed?
The splanchnic nerve block is minimally invasive, does not involve surgery, and is done using only local anesthetic. This treatment includes anesthetizing the splanchnic nerves, thereby preventing or “blocking” the nerves from transmitting information about pain sensations within the abdomen to the spinal cord and brain.
There are several methods by which physicians are able to anesthetize the splanchnic nerves. The most common method requires the patient to be lying on their abdomen. A local anesthetic is applied to the surface of the skin on the patient’s back. Using fluoroscopy (an x-ray) as a guide for proper placement, the physician inserts a needle into the eleventh thoracic vertebrae. Contrast dye is used to test for proper placement of the needle prior to injecting the anesthetic, as well as appropriate distribution of the solution within the area of interest. Once proper placement has been assured, the physician administers the anesthetic.
See a Splanchnic Nerve Block Performed Live!
In a neurolytic splanchnic block, alcohol along with a numbing agent is used to destroy the nerves that carry pain information, rather than simply impairing their functioning temporarily. Thus, the alcohol destroys the nerve tissues, preventing them from transmitting information about pain sensations within the nerves of the abdomen to the spinal cord and brain.
The procedure takes approximately 30 minutes to complete and significant reductions in pain are experienced almost immediately. Following the procedure, the patient is monitored for adverse reactions.
Many patients have reported significant improvements in their previously debilitating abdominal pain following a splanchnic nerve block. Further, a portion of these patients continue to feel relief from abdominal pain for many years. A series of splanchnic nerve blocks may be recommended as a treatment for chronic pain. If a patient experiences only temporary relief from pain symptoms following a splanchnic nerve block, then it is recommended that they undergo repeat injections. Generally, patients can expect the duration of pain relief following the procedure to increase following each administration.
Conditions Related To Splanchnic Nerve Block
The splanchnic nerve block is shown to be effective in reducing or relieving abdominal pain with a significant nerve, or visceral, component. In particular, patients suffering from chronic abdominal nerve pain are ideal candidates for a splanchnic nerve block. Individuals with pancreatic cancer have also been reported as having responded well to this pain management option, as well as patients suffering from malignancies of the liver, gallbladder, pancreas, stomach, small intestines, and kidneys.
Neurolytic blocks are less common and typically reserved for treating pain associated with malignancies of the upper abdomen, particularly pain that has been unresponsive to opioids. Nonetheless, neurolytic blocks have been utilized in treating chronic abdominal pain associated with non-malignant conditions.
The splanchnic nerve block is a minimally invasive, non-surgical treatment option for individuals suffering from abdominal nerve pain. This treatment option is particularly helpful to those patients whose pain has largely been unresponsive to opioid treatment or who have exhausted other conservative treatment options.
This intervention is ideal for individuals who are unable to tolerate the side effects of other pain medications. This procedure involves a relatively low risk and its pain-relieving effects can be experienced immediately. For individuals whose pain does not respond right away to the intervention, effects can be felt following a few repeat interventions.
Similar to other procedures involving steroid injections, researchers hypothesize that their effectiveness is related to their anti-inflammatory qualities. The literature, however, is still unclear.
- Baghdadi S, Abbas MH, Albouz F, Ammori BJ. Systematic review of the role of thorascopic splanchnicectomy in palliating the pain of patients with chronic pancreatitis. Surg Endosc. 2008;22(3):580-8.
- Bradley EL. Nerve blocks and neuroablative surgery for chonic pancreatitis. World J Surg. 2003;27(11):1241-8.
- Loukas M, Klaassen Z, Merbs W, Tubbs RS, Gielecki J, Zurada A. A review of the thoracic splanchnic nerves and celiac ganglia. Clin Anat. 2010;23(5):512-22.
- Noble M, Gress FG. Techniques and results of neurolysis for chronic pancreatitis and pancreatic cancer pain. Curr Gastroenterol Rep. 2006;8(2):99-103.
- Saltzburg D, Foley KM. Management of pain in pancreatic cancer. Surg Clin North Am. 1989;69(3):629-649.
- Wong GY, Sakorafas GH, Tsiotos GG, Sarr MG. Palliation of pain in chronic pancreatitis. Use of neural blocks and neurotomy. Surg Clin North Am. 1999;79(4):873-93.
- Zheng Q, Qi L, Hu Y. Effect and clinical value of splanchnic nerve block of hemodynamics in ACST. J Tongji Medical Univ. 1997;17(3):182-186.