Celiac plexus neurolysis (CPN)

The information on this page was reviewed and approved by

Maurie Markman, MD, President, Medicine & Science at CTCA.

This page was updated on December 2, 2021.

Celiac plexus neurolysis is a pain relief procedure used for patients with pancreatic cancer, but it’s sometimes also used for other abdominal cancers or pancreatitis. It’s also known as CPN or as a celiac plexus block.

If you have abdominal cancer, your care team may recommend CPN to help control your pain. The CPN procedure is an injection that damages the celiac nerves, a bundle of abdominal nerves located behind the pancreas. Its success stems from the fact that damaged nerves can no longer send messages of pain to your brain, so you’ll no longer feel discomfort from the cancer.

Why is celiac plexus neurolysis used?

CPN is used because it’s a powerful pain management tool. Due to the location of the pancreas, a pancreatic cancer tumor often presses on other nearby organs as it grows, causing many patients to experience severe pain in the:

  • Stomach
  • Back
  • Abdominal area

While many doctors prescribe opioid-based pain medication for this discomfort, you may still feel breakthrough pain. Sometimes, the medication isn’t successful, or it can cause side effects, such as:

  • Fatigue
  • Dizziness
  • Constipation
  • Nausea
  • Addiction

As an alternative to opioids, CPN is a useful tool to manage pain without the side effects associated with opioids such as oxycodone or codeine.

How to prepare for your procedure

If you’re scheduled to undergo a CPN procedure, your care team can outline exactly how to prepare, including any limitations on eating or drinking beforehand.

It’s also a good idea to arrange for someone to drive you home after you’re discharged.

What to expect

While your doctor will let you know ahead of time which technique will be used, a CPN can be done in three ways:

During the procedure, you can expect to:

  • Receive a local anesthetic to numb any pain
  • Potentially have a dye injected to help guide the doctor, via an imaging scan, to the exact injection site for the medication
  • Have alcohol injected into the celiac plexus, which damages the nerves so they can no longer send pain signals to the brain

The entire CPN procedure takes about 30 to 60 minutes as outpatient surgery.

You may start feeling pain relief very shortly after it’s finished. After an observation period, you’re usually free to go home.

Your care team can provide you with clear aftercare instructions, so always follow their guidelines to maximize your recovery.

Benefits of celiac plexus neurolysis

Because a CPN injection is safe and well-tolerated with few side effects, it makes for a good alternative to daily pain medication. Once the procedure is complete, over the long term, you should have no pain or greatly reduced pain.

For some patients, this can completely eliminate the need to take pain medication.

Risks of celiac plexus neurolysis

You may experience side effects after a CPN procedure. Some of the most common include:

  • Discomfort, swelling or muscle spasms near the injection location
  • Diarrhea
  • Low blood pressure
  • Infection
  • Allergic reaction

More serious side effects—such as kidney damage and seizures—are less common, but still possible.

If you feel unwell after your procedure, contact your care team right away.

How will I know if my procedure was successful?

Usually, you’ll know immediately if your CPN was successful, because you’ll start to feel reduced pain. If you still feel pain after a CPN, your doctor can help you manage your pain levels and discuss additional treatment options with you.

As always, your care team is there to help, so be sure to talk to them if you have any questions or concerns about pain throughout your cancer treatment.

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