Overview of Ganglion Impar Block in Las Vegas

The ganglion impar block is used to treat conditions that cause pain in the coccyx area (tailbone region). The ganglion impar is a bundle of nerves located right in front of the coccyx bone. These nerves are associated with the sympathetic nervous system, and they supply the urethra, vagina, distal rectum, perineum, and scrotum.

What conditions respond to the ganglion impar block?

The ganglion impar block is used to treat perineal pain of a chronic nature. Visceral pain occurs from upper abdominal cancer, chronic pelvic pain, chronic pancreatitis, rectal cancer, and perineum cancer. The block is also useful for treating failed back surgery syndrome, post-herpetic neuralgia, and spinal cord malformations.

What type of pain is treated with the ganglion impar block?

The ganglion impar block helps treat sympathetic or visceral neuropathic pain. This pain is often poorly localized and causes a burning sensation.

How is the ganglion impar block done?

There are several approaches to performing the ganglion impar block. The transsacrococcygeal approach is most commonly used, and this involves insertion of the needle through the posterior region. Other approaches include the paramedical approach and the paracoccygeal corkscrew approach.

How do you prepare for the ganglion impar block procedure?

Most blood-thinning agents must be held for several days prior to the procedure, so you should notify the doctor of which medicines you are taking. Do not eat or drink after midnight, and bring someone to drive you home. When you arrive at the medical facility, a nurse will go over the pros and cons of the procedure and have you sign a consent form. After changing into a gown, the nurse will place an IV catheter in your arm.

How is the ganglion impar block procedure performed?

The doctor will position you on your stomach and place pillows under your hips for support. The nurse monitors your heart rate, blood pressure, and oxygen level using simple devices. The skin of the very low back is cleaned with an antiseptic solution, and a local anesthetic is used to numb the region. X-ray guidance (fluoroscopy) is used to assure needle placement, and the anesthetic is instilled onto the nerves.

What can I expect after the ganglion impar procedure?

After the ganglion impar block procedure, a nurse will monitor you for around 30 minutes. Side effects include soreness at the injection site, dizziness, and mild drowsiness. We recommend that you take it easy for a couple of days, and gradually return to activities as tolerated. Soreness at the site is relieved by using an ice pack for 20-minute intervals several times each day.

What risks are associated with the ganglion impar block?

This block is effective and safe, as it is a minimally invasive procedure. However, risks can occur, including infection, nerve damage, bleeding, and blood vessel damage.

Is the ganglion impar block effective?

According to a recent clinical study, the ganglion impar block had an efficacy rate of 75%. In this study, 37% of participants reported complete symptom relief with the block. Another research study found that the block reduced pain scores by 50%, with pain relief noted for up to three months following the procedure.

Resources

Datir, A & Connell, D (2010). CT-guided injection for ganglion impar blockade: a radiological approach to the management of coccydynia. Clinical Radiology, 65(1), 21-25.

Kim ST, Ryu SJ. Treatment of Hyperhidrosis Occurring during Hemodialysis: Ganglion Impar Block: A case report. Korean J Anesthesiol. 2005 May;48(5):553-556.

Toshniwal GR, Dureja GP, Prashanth SM. Transsacrococcygeal approach to ganglion impar block for management of chronic perineal pain: a prospective observational study. Pain Physician. 2007 Sep;10(5):661-6.