Splanchnic Nerve Block

//Splanchnic Nerve Block
Splanchnic Nerve Block 2018-12-20T11:55:05+00:00

What Is A Splanchnic Nerve Block?

If you’re suffering from cancer, you know that the pain and discomfort that accompanies cancer and many of its treatment can be one of the most distressing aspects of the condition. These symptoms can be quite severe and debilitating. For many, they can lead to detrimental impacts on your mood, energy, and willingness to complete necessary treatments. Moreover, cancer pain is often unresponsive to typical pain management techniques. For these patients, a more significant intervention for pain management may help. Splanchnic nerve blocks are one such procedure, used especially for stomach pain. Here’s what you should know about the procedure itself, benefits, and any risks.

What are the splanchnic nerves? 

Originating from the 11th and 12th thoracic vertebrate, the splanchnic nerves extend down along each side of your spinal column. These splanchnic nerves terminate at the celiac plexus within the abdomen. Their primary function is to relay sensory and motor information from the abdominal region to the spinal cord and brain.

The splanchnic nerve block is a minimally-invasive treatment option for pain that originates in these nerves. Splanchnic nerve blocks effectively treat neuropathic pain originating from the abdominal region by impeding, or blocking, the transmission of pain information from the area to the spinal cord and brain.

After a splanchnic nerve block, these signals of pain that originate from within the abdomen are blocked before they can reach your spinal cord. Thus, this significantly reduces or even eliminates your subjective degree of pain severity. Because it is minimally-invasive, it can help you avoid more intensive surgery.

Could A Splanchnic Nerve Block Help Me?

This treatment approach can help patients with severe and chronic symptoms of abdominal pain. Moreover, patients who report pain and discomfort that has been unresponsive to previous pain treatments may be ideal candidates for the procedure. This treatment approach helps reduce or relieve symptoms of neuropathic pain that can occur from issues or cancer in the:

  • Pancreas, including pancreatitis and pancreatic cancer
  • Gallbladder
  • Liver
  • Stomach
  • Small intestines
  • Kidneys

Patients who are suffering from pancreatic cancer endure the most severe symptoms of cancer pain. Splanchnic nerve blocks may be an ideal treatment option for managing this very severe and refractory pain. Though they’re less common than traditional splanchnic nerve blocks, neurolytic blocks can help patients who are suffering from malignancies of the upper abdomen.

How Is A Splanchnic Nerve Block Performed?

Splanchnic nerve blocks are an interventional method for managing pain. They are minimally invasive and do not require surgery. In fact, in many instances, splanchnic nerve blocks can be done using only a topical local anesthetic. The procedure itself takes less than an hour to complete.

There are several methods to perform this procedure. The most common technique requires that a patient starts the procedure by lying face down. Their healthcare team thoroughly cleans and sanitizes the injection site. Their doctor will use a fluoroscopic device to help them find correct placement for the injection needle. For splanchnic nerve blocks, the needle is positioned into the 11th thoracic vertebrae.

It is not uncommon for physicians to insert a contrast dye prior to injecting the anesthetic. This allows them to ensure that the needle has been properly placed. It also provides them with an idea of the distribution area. Once the correct location of the injection needle has been verified, the physician will inject the anesthetic solution. During neurolytic splanchnic blocks, alcohol is added to the anesthetic solution. While the anesthetic effectively numbs the area by temporarily inhibiting the function of the nerves, the alcohol can permanently destroy neural tissue.

In most cases, the procedure takes approximately 30 minutes to complete. Once the splanchnic nerve block procedure is done, patients will be monitored for any adverse reactions from the procedure or the medication before being discharged.

Splanchnic nerve block risks

As with most medical procedures, there are some risks associated with splanchnic nerve blocks. Following the procedure, some patients may experience a drop in blood pressure. Additionally, gastrointestinal distress is common. Symptoms of nausea generally resolve within a couple of hours. Patients can expect to have loose stools following a splanchnic nerve block, as well.

Other side effects that may occur include:

  • Bleeding at the site of the injection
  • Slight bruising
  • Infection
  • Minor pain at the site of the injection
  • Temporary impairment in sexual functioning

Most side effects and risks are mild and relatively rare. If you’re experiencing severe symptoms, contact your doctor.

How long does a splanchnic nerve block last?

Many patients will report relief from pain and discomfort almost immediately. In other instances, it may take several days before you experience the full pain relieving benefits of the procedure. After, a portion of patients can expect to remain pain-free for several years following the procedure.

For patients who do not experience full pain relief, repeat injections may help. In these instances, evidence suggests that the length of time the patient is pain-free increases following each injection.

Conclusion

Splanchnic nerve blocks are a minimally-invasive, non-surgical intervention for managing severe and refractory neuropathic stomach pain. If other more conservative pain treatments haven’t worked, your doctor may recommend this procedure.

Patients who are interested in learning more about this procedure should speak with their doctor about the risks and benefits of splanchnic nerve blocks. If you’re not already working with a pain specialist, you can find a pain doctor in your area by clicking the button below or looking for one in your area by using the tips here: https://paindoctor.com/pain-management-doctors/.

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References

  1. 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.
  2. Bradley EL. Nerve blocks and neuroablative surgery for chonic pancreatitis. World J Surg. 2003;27(11):1241-8.
  3. 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.
  4. Noble M, Gress FG. Techniques and results of neurolysis for chronic pancreatitis and pancreatic cancer pain. Curr Gastroenterol Rep. 2006;8(2):99-103.
  5. Saltzburg D, Foley KM. Management of pain in pancreatic cancer. Surg Clin North Am. 1989;69(3):629-649.
  6. 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.
  7. 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.

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