Splanchnic Plexus Radiofrequency Ablation (RFA) is a cutting-edge procedure for managing chronic upper abdominal pain, especially in cancer patients and those with chronic pancreatitis. It uses radiofrequency energy to ablate pain- transmitting nerves, providing long-lasting relief.

At LiveWell Hospital, the procedure is performed by experts using advanced imaging for precision and safety. The hospital’s specialized pain management services and modern technology ensure superior outcomes. LiveWell is recognized as a leading center for splanchnic plexus RFA in Gujarat, offering comprehensive, patient-centered care.

Splanchnic plexus RFA is indicated for:

1. Cancer Pain:

1. 1. Upper abdominal cancer pain (e.g., pancreatic cancer, gastric cancer, hepatobiliary cancer).
   2. Intractable pain unresponsive to opioids or intolerant to opioid side effects.

2. Chronic Pancreatitis Pain:

1. 1. Severe and refractory pain not controlled with conservative or medical therapies.

3. Other Abdominal Pain Syndromes:

1. 1. Non-cancer chronic visceral pain in the upper abdomen (rare indications).

4. Failed Sympathetic Blocks:

1. 1. Patients who responded well to diagnostic or therapeutic splanchnic nerve block.

1. Patients with well-localized upper abdominal visceral pain.
2. Those who had significant pain relief from a diagnostic or therapeutic splanchnic nerve block (using a local anesthetic).
3. Patients who are medically fit for minimally invasive procedures.
4. Those who require long-term pain relief and want to minimize opioid use.
5. Exclusion Criteria:
   1. 1. Coagulopathy or active infections.
      2. Pregnancy (relative contraindication).
      3. Patients with psychiatric conditions that might impair cooperation.

 1. Preparation:

1. 1. Ensure imaging (CT/MRI) to confirm pain source.
   2. Informed consent and explanation of risks and benefits.
   3. Sedation or local anesthesia as required.

2. Positioning:

1. 1. The patient is positioned prone with a pillow under the abdomen for comfort.

3. Imaging Guidance:

1. 1. Use fluoroscopy or CT for precise needle placement.

4. Needle Insertion:

1. 1. Insert needles bilaterally under imaging guidance to reach the anterolateral border of the T12 or L1 vertebral bodies, where the splanchnic nerves are located.
   2. Confirm correct placement using contrast dye to avoid vascular or organ penetration.

5. Radiofrequency Ablation:

1. 1. Connect the RF generator to the needles.
   2. Perform sensory and motor stimulation to confirm correct nerve targeting.
   3. Ablate the splanchnic nerves using RF energy (80°C for 60–90 seconds).

6. Post-Ablation Testing:

1. 1. Confirm pain relief during the procedure.

1. Immediate Monitoring:

1. 1. Observe for at least 2–4 hours post-procedure for complications.
   2. Monitor for hypotension, as sympathetic blockade can reduce vascular tone.

2. Pain Relief Assessment:

1. 1. Assess pain reduction and functionality improvement.

3. Activity Restrictions:

1. 1. Advise rest for 24–48 hours.
   2. Gradual return to activities as tolerated.

4. Complication Awareness:

1. 1. Look for symptoms of potential complications, including:
   2. Bleeding, hematoma, or infection at the injection site.
   3. Diarrhea or abdominal cramping (temporary).
   4. Neuralgia or dysesthesia.
   5. Rarely, organ injury or paralysis (from misplacement).

5. Follow-Up:

1. 1. Regular follow-up to assess pain relief, side effects, and the need for additional interventions.