Visceral Pain Procedures
Abdominal and pelvic pain is mediated by nerves that coalesce with specific ganglia in near the lumbar spine. The well-defined location of these ganglia allow for interventions designed to alleviate chronic abdominal or pelvic pain. Abdominal pain may be treated with a celiac plexus axis intervention. The celiac plexus is located just anterior to the aorta at the L1 vertebral level. For malignant pain such as pancreatic, stomach or liver cancer, this intervention may consist of the precise injection of alcohol which destroys the nerves that mediate pain.
This is a precise injection that requires X-ray localization and intense post-procedure monitoring and treatment of side-effects. Prior to the neurolytic block, a diagnostic block with local anesthetic is usually performed in order to demonstrate efficacy of the technique and lack of serious complications. For benign pain conditions that demonstrate short-term improvement with local anesthetic celiac plexus block, radiofrequency neuroablation of the bilateral greater and lesser splanchnic nerves may be performed.