Ganglion Impar Block

What is Ganglion Impar?

The ganglion of impar is a network of nerves that are located just front of to the tailbone and supplies some of the function and sensation to the anorectal region and tailbone. Over- activity of these nerve cells may cause chronic tailbone pain.

What is Ganglion Impar Block Injection?

The Ganglion impar block injection is a minimally invasive procedure that can be used to diagnose or used as a treatment for chronic pelvic and rectal pain, including tailbone pain (coccydynia).

How is it Performed?

The patient lies on his/her stomach. With continuous monitoring of the patient, the skin on the target area (tailbone) is painted with an antiseptic solution and numbed with the local anaesthetic. Using either fluoroscopic guidance (real-time x-ray) or ultrasound guidance, the needle tip is placed at the targeted area & its position is confirmed with the help of the spread of the contrast (dye). Then, a low volume anaesthetic with anti-inflammatory medication is injected. Then the patient is monitored in the recovery room prior to discharge

The procedure takes approximately 15-20 minutes

What risks are Involved with a Ganglion Impar Block?

A ganglion impar block is a very low risk procedure.

Serious side effects and complications are very rare. Pain at the injection site, local bruising, headache, nausea, fainting, or dizziness are some of the most common side effects, which are transient and will subside on their own. The other uncommon complications are infection, bleeding and nerve injury. These complications are minimized by timely stopping blood thinners, using sterile technique, and fluoroscopic or ultrasound guided needle placement.

How Long Does the Effect Last?

The effect might last a few weeks to few months, or sometimes much longer. If there is significant improvement in pain, no further injection is needed unless the pain recurs. Whenever the pain recurs, the injections may be repeated for an added benefit in future. Even if the effect lasts only for a short time, it has still helped your physician with diagnostic information to plan for the future treatments.

What is the Next step after the Injection?

It is very important for you to maintain the PAIN DIARY following this injection and bring it with you during your next follow up visit with doctor. This will guide us to measure your response to the treatment and decide the next most appropriate plan.

How Does It Work?

Signals between the sympathetic nervous system and pain fibres are interrupted from multiple structures simultaneously, leading to a very good pain relief. This can be used for diagnostic purposes as well as therapeutic.

• Diagnostic: To determine if the pain is sympathetically mediated or not.
• Therapeutic: To treat the pain at the source.

What Should be done after Injection?

• Avoid self-drive on that day alone.
• Avoid doing strenuous activity r 12-24 hours after the procedure
• Following the treatment, the patient is advised to do all the exercises and take all the medications as prescribed. The patient may resume their work from next day.
• Maintain the PAIN DIARY to have a record on your pain.

Who are the Eligible Candidates for Ganglion Impar Block Injection?

Candidates that may benefit with a ganglion impar block include perineal pain coming from:

• Coccyx (tailbone)
• Anal & perineal region
• Distal urethra
• Vulva or distal third of vagina
• Cancer that has spread to perineum
• Sacral postherpetic neuralgia
• Other perineal pain conditions