The term “splanchnic nerve block or destruction” refers to the temporary or permanent interruption of the function of splanchnic nerves, which are responsible for transmitting painful stimuli from the internal organs of the body, such as the pancreas, stomach, kidneys, and gallbladder, to the brain.
Therefore, interrupting their function results in the elimination of pain caused by pathology in these organs.
A splanchnic nerve block or destruction is primarily applied in patients with malignant disease of these organs, i.e., cancer pain.
There are three methods:
The patient is positioned prone, and after local anesthesia and antisepsis are applied to the area where the splanchnic nerves pass (approximately at the level of the 11th thoracic vertebra, around the middle of the spine), a needle is advanced under fluoroscopic guidance so that the physician can monitor its trajectory and final position.
Then, a local anesthetic is injected, which temporarily blocks the function of the nerves. The duration of the effect depends on the type of anesthetic used.
Due to the limited duration, this technique is usually applied diagnostically to determine whether chronic pain is indeed caused by the underlying disease. If effective, a more permanent method is then suggested to the patient to address their problem.
This technique is similar to the local anesthetic injection, but in this case, 95% alcohol is injected in large quantities. The effect lasts 2-5 months.
This is considered the safest technique with the longest duration of action for managing chronic cancer pain.
Are the results immediate?
The results are immediate, and the patient experiences relief from their problem. The duration of effect depends on the technique used, with radiofrequency being considered the safest and most effective method.
Are there risks with splanchnic nerve block or destruction?
When performed by an experienced physician and with the help of fluoroscopic guidance, the risks are minimal and can be managed with appropriate medication. One of the most common complications is the occurrence of abdominal pain and diarrhea due to increased intestinal motility, which, however, lasts for a short period and subsides with medication.
