04 Apr Splanchnic Nerve Blocks for Chronic Nerve Block
What Areas Does the Splanchnic Nerve Effect
One of the treatment options for abdominal pain is called a splanchnic nerve block, and this can help with pain that is not treatable with medications or other types of therapy. These procedures involve the injecting of anesthetic medication into a bundle of nerves to numb any pain.
The splanchnic nerves go from the spinal cord to the celiac plexus where these nerves affect the abdomen. These nerves communicate signals of pain from the abdominal organs (stomach, kidneys, small intestine, gall bladder, pancreas, liver, adrenal gland and spleen) to the spinal cord where continues on to the brain. Those patients who are suffering from any cancer-related abdominal pain, chronic abdominal pain, or chronic pancreatitis receive relief from this pain with a splanchnic nerve block.
Anatomy of Three Splanchnic Nerves
The 3 splanchnic nerves – greater, least and minor – come from the thoracic spinal nerves at the 11th and 12th thoracic vertebrae locating at a point that is right above the arch way of the diaphragm in an area known as the retro peritoneum.
These nerves all terminate at the celiac plexus, located in the abdomen very close to the aorta. The celiac plexus in turn communicates with the organs in the abdominal region from the level of the colon to the lower esophagus.
Splanchnic Nerve Block Procedure
The patient will lie on the stomach and local anesthesia is then injected to numb the skin and make the entire procedure more comfortable for the patient. Sedation intravenously might be administered allowing the patient to be very calm and relaxed during the procedure.
First, a temporary nerve block in the form of anesthetic is administered to the splanchnic nerves to better assess how affective this treatment is in relieving the pain the patient has. A needle is then bilaterally inserted to the 11th thoracic vertebra and when the proper position has been verified by fluoroscopy (X-ray with dye for visualization) anesthetic is then injected into the nerves.
This local medication numbs the splanchnic nerves and will inhibit any communication of pain messages to the brain. This procedure usually takes less than one-half hour. A splanchnic nerve block that is successful is evidenced by profound pain relief.
More Long Term Relief Involving Splanchnic Nerves
Individuals who have verifiable pain relief from a block where local anesthetic is injected into the splanchnic nerves are excellent candidates for a more enduring nerve block. Alcohol injected to these nerves weakens the capacity to conduct pain messages and might provide 2 or 3 months of pain relief.
Local anesthetic is then injected, and then radiofrequency ablation of the nerves is directed to the splanchnic nerves. This technique affects only a precise area, usually with no negative effects to surrounding tissues and nerves. It also results in a long-term relief of pain.
Benefits of Splanchnic Nerve Block
Following a splanchnic nerve block, most patients with unmanageable, chronic, abdominal pain associated to cancer or inflammation report pain relief that is profound. This allows these individuals to have a better quality of life, leading a much more bodily active as well as independent lifestyle. A splanchnic nerve block might reduce the patient’s dependence on medications known as opioid as well as freeing them from unwanted side effects such as constipation, drowsiness, and confusion.
Risks from Splanchnic Nerve Block
Splanchnic nerve block is considered a minimally invasive procedure that is low-risk. Rarely, patients may experience complications such as: infection at the injection site; misplacement of the needle causing bleeding or pneumothorax; hypotension which is low blood pressure; increase in bowel movements or diarrhea; and allergic reaction to medication. But these usually resolve themselves within 3 days.