The Ganglion Impar is a cluster of nerve cells and supporting tissue, which is part of the sympathetic nervous system located in front of the sacrum/coccyx joint. The autonomic innervation to the majority of abdominal organs flows through the celiac plexus. This includes the pancreas, liver, gallbladder, stomach, small intestine, and the ascending and transverse portion of the colon.
It is an injection of an anti-inflammatory steroid medication and local anesthetic deposited around the Celiac Plexus to help manage abdominal pain. The steroid shrinks swelling around the nerve roots and the local anesthetic numbs the inflamed areas and relaxes the muscles around the Celiac Plexus. To ensure proper placement of the medication, the procedure is performed under CT scan guidance.
A Celiac Plexus block is performed to diagnose and reduce abdominal pain caused by conditions such as cancer or pancreatitis. This procedure blocks the nerves which come from the pancreas, liver, gall bladder, stomach and intestine. A celiac plexus block consists of injections of a local anesthetic, steroid or ethy-alcohol. The use of alcohol, called a neurolytic block, destroys the nerves. A trial block is done, using a local anesthetic, before a neurolytic block is performed.
Upon registering at the Southwest Ohio Pain Center, you will be taken to radiology department where we will begin your procedure. You will be asked to lie face down on the CT scan table and your low back will be cleansed with anti-septic solution and numbed with an anesthetic. This is felt as a stinging / burning sensation. Under the CT guidance, the doctor will insert the needle near the plexus and inject the anesthetic medicine. You may experience some increased discomfort. The procedure takes approximately 30 minutes. A band-aid will be applied at the needle insertion site, which may be removed the next morning. You will be discharged when the physician authorizes and you are stable.
The most common side-effects include transient diarrhea and hypotension (low blood pressure). Some risks, although remote include: bleeding, infection, nerve injury, and allergic reaction to the medication(s). Diabetics may have short-term elevation of blood sugars. People prone to fluid retention may have increased fluid retention for 1 -2 weeks.
Relief varies from one person to the next. The only way to know if it will work for you is to have it performed. The steroid may take several days to work and peaks in about 2 weeks. Therefore, it may be several weeks before you feel a change in your pain. You may apply ice to the affected area for 20 minutes every 2 hours to decrease local tenderness. After the first day, you can perform activities as before and return to work.
You may NOT drive for the remainder of the day after your procedure. No heat is to be used on the injection area for the remainder of the day. No tub bath or soaking in water (pools/Jacuzzi, etc) for the remainder of the day.
If you experience severe back pain, new numbness or weakness of your legs, loss of control of your bladder or bowels, or have signs of infection (temperature greater than 99.9º , drainage, redness/heat at insertion site) – call IMMEDIATELY.
ON THE DAY OF YOUR PROCEDURE, PLEASE DO THE FOLLOWING:
♦ Take all blood pressure pills & heart medications prior to the procedure with a sip of water at least 3 hours before your requested arrival time. Your vitals must be stable to have the procedure.
♦ Have a responsible person to take you home.
♦ Arrive at the requested procedure time. Please do not be late or your procedure may be cancelled.
ON THE DAY OF YOUR PROCEDURE:
♦ Do not take ANY of the following 5 days before your procedure: Coumadin
♦ Do not take ANY of the following 7 days before your procedure: Plavix
♦ Coumadin must be stopped prior to the injection. You must have a normal INR prior to the injection. Do not stop the drug by yourself.
♦ Eat or drink 6 hours before the procedure.
NOTE: YOUR PROCEDURE WILL BE CANCELLED IF:
- You have an active infection, flu, cold, fever, or very high blood pressure.
- You do not have a responsible driver to take you home, arrive late for your procedure, or unable to follow the medication / fluid restrictions.
Call the office at (513) 860-1039 for procedure related questions.