What is a Splanchnic Nerve Block?

Splanchnic nerve block explained by Denver, Golden, Aurora, Boulder, Broomfield, Jefferson, and Littleton Colorado’s top pain doctors

Cancer-PainA splanchnic nerve block is a minimally invasive treatment approach for individuals suffering from persistent abdominal pain that does not require surgery. This procedure has been shown to effectively relieve or reduce pain caused by inflamed nerves in patients who have pancreatitis, pancreatic cancer, and additional conditions that affect the gallbladder, stomach, kidneys, liver, pancreas, and the small intestines.

Splanchnic nerves originate in the thoracic vertebrate and extend down the spinal column on both sides into the celiac plexus in the abdomen. These nerves regulate the transfer of sensory information between the spinal cord, brain, and abdomen. Therefore, the purpose of a splanchnic nerve block is to hinder pain signal transmission in order to reduce or completely alleviate abdominal pain.

Research has indicated that pancreatic cancer patients typically report experiencing a significant amount of pain due to this condition. The pain can be physically and emotionally debilitating and can negatively affect a patient’s mood, attitude, motivation, and energy level during treatment. Conventional intervention methods (e.g., opioids) are often ineffective at relieving the pain that is caused by pancreatic cancer and this leaves patients feeling desperate.

How is a Splanchnic Nerve Block Performed?

Splanchnic Nerve BlockA splanchnic nerve block is not a surgical procedure and can be performed with local anesthesia, which makes it minimally invasive. The anesthesia is injected directly into the abdominal region where the splanchnic nerves are located in order to prevent or block pain signal transmission from the nerves to the brain and spinal cord.

Physicians have established several techniques that can be utilized to deliver the anesthesia to splanchnic nerves that are inflamed. The quickest and most commonly utilized approach involves the patient lying on the abdomen. Local anesthesia is administered to the skin and then an imaging device such as a fluoroscope (X-ray) is used to guide the thin needle that is inserted into the thoracic vertebrae. In addition, a contrast dye is injected to help ensure that the needle will be properly placed before the anesthetic is injected and to make sure that the medication will be appropriately distributed to the targeted region. The anesthetic is then injected into the vertebrae closest to the affected nerves.

A different approach, called a neurolytic splanchnic block, entails injecting alcohol and an anesthetic in order to destroy the inflamed nerves that transmit pain signals, as opposed to temporarily hindering their ability to transfer sensory information. The alcohol is the component that destroys the targeted nerves.

The entire procedure can be performed in 30 minutes and patients usually report an immediate and significant decrease in pain after the injection. Patients are also monitored after the procedure in case harmful side effects begin to develop. Many patients who have received a splanchnic nerve block reported a dramatic reduction in the unbearable abdominal pain that they had previously suffered from. Furthermore, some patients even experience abdominal pain relief that lasts for several years. If the initial splanchnic nerve block is only slightly effective, it may be repeated in order to enhance its effect or to treat chronic pain. The extent of the pain relief increases after each injection.

Conditions Related To Splanchnic Nerve Blocks

Abdominal PainSplanchnic nerve blocks effectively reduce or completely alleviate abdominal pain that is caused by visceral or nerve damage. Clinical trials have also shown that pancreatic cancer patients achieve significant relief from treatment in addition to individuals who have malignancies of the gallbladder, kidneys, liver, stomach, pancreas, and small intestine.

The neurolytic splanchnic block is performed less often and is usually only recommended for the treatment of pain that is caused by malignancies in the upper abdomen, especially if previous treatment methods, such as opioid treatment, were unsuccessful. Occasionally, neurolytic blocks have also been utilized for the treatment of abdominal pain that is the result of conditions that are non-malignant.

Conclusion

A splanchnic nerve block is an effective treatment for chronic abdominal pain that is minimally invasive and does not require surgery. This treatment approach is especially helpful for patients who did not notice a difference in their level of pain after taking opioids or those who have tried a variety of conservative methods. This nerve block is also ideal for patients who experienced unbearable side effects from pain medication. The risks associated with a splanchnic nerve block are minimal and patients generally report experiencing almost immediate pain relief after the procedure. If an individual does not notice an improvement after the initial block, the procedure can be repeated several additional times.

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References

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