Celiac Plexus Blocks and Splanchnic Nerve Blocks

Nerve blocks of the celiac axis are a valuable tool for the comfort and pain relief of patients with acute and chronic pain generated from the abdominal viscera. Sources most commonly include abdominal cancers and primarily pancreatic cancer. A local anesthetic or neurolytic solution is used to temporarily or permanently block the celiac plexus nerves from transmitting pain signals from the abdomen to the brain. Understanding the anatomy, pathophysiology, and effect/side effect profile of this block is necessary for performing the block. Though performing this block has been described with and without various forms of imaging, two mainstream techniques using fluoroscopic guidance, transcrural and retrocrural, are discussed and explained in detail.