c6- Ganglion Impar Block
- What is Ganglion Impar, where is it located, and what is its function?
The Ganglion Impar is a nerve bundle located on the anterior surface of the coccyx. It controls the pain sensation of the genital organs and the terminal part of the digestive system, as well as the function of the blood vessels. A Ganglion Impar block involves numbing this nerve bundle with a local anesthetic in front of the coccyx.
- What conditions is the Ganglion Impar Block used for?
- In lesions of the coccyx bone due to acute or chronic trauma to the tailbone,
- Pain due to stimulation of this nerve bundle can occur in diseases related to the genital organs or the anus.
- What is the Ganglion Impar block, what is its purpose, and how does it work?
The purpose of the block is to deactivate the nerves of this overly active nerve bundle. When this overactivity is blocked, there is a significant improvement in symptoms.
- What preparations are required for the procedure?
No fluids or food should be consumed 4 hours before the procedure. However, any medication you are taking for other conditions should be taken with a small amount of water as approved by your doctor. Inform your doctor about any drug allergies during your initial visit. Come without jewelry such as necklaces, earrings, watches, rings, and bracelets. Due to the effects of the sedation applied during the procedure on mental functions and the potential for weakness in the legs due to the local anesthetic, you will not be allowed to drive. Therefore, you should come with a relative who can accompany you after the procedure.
- What are the benefits of the procedure?
Pain usually begins to decrease within 15-20 minutes after the procedure.
- How is it administered?
Before the procedure, you are required to sign an informed consent form as a legal requirement. A vein is opened for the patient, then taken to the operating room conditions, and measurements of pulse, blood pressure, blood oxygen level, and respiration are taken. These values are continuously monitored during the procedure. The patient lies face down, and a pillow can be placed under the abdomen if necessary. Then, sedative drugs are administered through the vein. The area is cleaned and draped with antiseptic solutions. The injection site is then determined and confirmed through an imaging device. After numbing the entry point with a local anesthetic, the site is reconfirmed under the imaging device by administering a contrast agent, and a mixture of local anesthetic with steroid is injected to perform the block. Afterwards, the patient is taken to their room and observed for about 2 hours. At the end of the observation period, the patient is sent home with an accompanying relative.
- What can happen after the procedure, and what are its benefits?
Pain at the needle entry site may occur, which usually responds to analgesic treatment. Penetration of the blood vessels at the site of intervention can lead to bleeding, and penetration into the abdominal organs can cause damage to these organs. However, all of these are extremely rare. With correct use of the imaging device, these complications are almost nonexistent. Immediate post-procedural pain relief and a decrease in other complaints indicate the success of the procedure. Pain can decrease immediately after the procedure but may increase from the 2-3rd day to the 7th day. This pain is related to the procedure itself and can be easily controlled with prescribed pain medications. By the end of the first week, the treatment gradually starts to take effect, and a significant improvement in pain and other complaints is observed over a period of about 3 weeks.
- What is the purpose of the Ganglion Impar block?
The purpose of the block is to block the nerves of the sympathetic nervous system in the lumbar region.
- How long does the procedure take?
The procedure takes 15-20 minutes and is performed under operating room conditions. Since the patient is observed after the procedure, the total duration of the hospital stay may be 3-4 hours.
- Is the procedure painful, is anesthesia given?
The needle entry site is numbed, and sedation is administered through intravenous sedative drugs, so you do not feel pain. Sedation is not general anesthesia; it only provides a short-term loss of memory and a period without pain. Since the procedure is very short, there is no need for general anesthesia.
- What should I do after the procedure?
Rest for 4-5 days is recommended after the procedure. You can attend to your needs such as eating, toileting, and bathing. Apart from these, you should rest continuously in a lying position that does not cause discomfort. Patients who work are given a report to take time off from work.
- Can I start work the day after the procedure?
Since four to five days of bed rest is required, working patients are given a report to take time off from work. After the period of rest, you can return to your daily activities and work.
- How long does the effect of the procedure last, how many injections are needed? Analgesic efficacy lasting for months can be achieved after repeated blocks. While some patients may be treated with 1-2 injections, others may not experience any effect.
- Will the block be beneficial for me?
It is unpredictable how it will work for any given patient. Effectiveness tends to be higher in patients who seek treatment early, while those who have had symptoms for more than 6 months tend to have lower success rates.
- What are the risks and side effects?
Although the procedure is extremely safe, risks, side effects, and potential complications that can occur with all interventions can rarely occur with the Ganglion Impar Block as well. The most common side effect is pain at the site of intervention, which is temporary. Other risks include bleeding, infection, and injection into nearby vessels or organs. These side effects are extremely rare.
- Who should not undergo a Ganglion Impar Block?
It is not performed on patients who have allergies to the drugs used during the procedure, those on blood thinners such as Coumadin or Plavix, or those with an active infection in the area of the procedure or anywhere else in the body.
