Celiac Plexus Block

Excerpt

First introduced as a technique for providing surgical anesthesia in upper abdominal procedures, the celiac plexus block (CPB) has been used for almost a century. Functioning as a versatile multimodal adjunct in the management of abdominal visceral pain, the CPB targets the intricate celiac plexus, encompassing the celiac, superior mesenteric, and aorticorenal ganglia, which form an extensive neural network, often referred to as the solar plexus. This network orchestrates autonomic innervation for various abdominal organs, including the liver, gallbladder, stomach, pancreas, spleen, kidneys, small bowel, and the initial two-thirds of the large bowel.

Primarily, the CPB is deployed to address afferent nociceptive fibers, rendering it valuable as both a diagnostic and therapeutic tool for managing intraabdominal pain. CPB is indicated in cases of intractable abdominal pain refractory to less aggressive analgesic interventions and is mainly used in the palliation of pain related to malignant and benign neoplastic conditions affecting abdominal organs, with pancreatic cancer the most prevalent. However, using CPB in chronic pancreatitis remains a subject of debate.