Lumbar Sympathetic Ganglion Block

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What is Lumbar Sympathetic Ganglion Block?

A lumbar sympathetic ganglion block is an injection of local anesthetic into or around the sympathetic nerves, which are a part of the sympathetic nervous system. The sympathetic nerves are located in the lower back, on the either side of spine. Lumbar sympathetic ganglion block is an interventional pain procedure. This procedure is performed to get long term pain relief of 4 to 6 months or more.

The lumbar sympathetic ganglion block is considered for following diseases

Diabetic neuropathy.

Complex regional pain syndrome or reflex sympathetic dystrophy.
Peripheral vascular disease.

Post-herpetic neuralgia involving the lower extremities.
Phantom Pain.

How is Lumbar Sympathetic Ganglion Block Procedure Done?

The procedure of lumbar sympathetic ganglion block is usually performed in an out-patient setting under local anesthesia. It is given in the form of injection, which helps to numb the area when actually injecting the block. This procedure may take around 30 minutes.

Preparation for Lumbar Sympathetic Ganglion Block

A decision for lumbar sympathetic ganglion block is made only after clinical examination and thorough evaluation of patient’s condition, medical reports, etc. Any existing medical condition like high levels of blood sugar, high blood pressure needs to evaluated and a decision for procedure is made once these levels are controlled.

Lumbar sympathetic block procedure is done in fasting, so follow your physician's advice regarding food, medicine and other routine.

Details of the procedure, the reasons for doing it and its possible effects are clearly explained to you. Appropriate formalities, informed consent form and documentation is done.

Procedure for Lumbar Sympathetic Ganglion Block:

Lumbar sympathetic ganglion block is performed by an interventional pain specialist. It is done under mild to moderate sedation. Patient is made to lie in prone position on the x-ray compatible surgical table. A flexed prone position is maintained by placing a pillow under abdomen.

With appropriate procedure aseptic precautions, the skin in the lumbar region to be injected is cleaned and prepared for the lumbar sympathetic ganglion block. Further, the procedure is guided by x-rays for appropriate position of the needle and to confirm the path of the injected medication. An aseptic needle is inserted in the back to reach the desired point in the spine. A dye is then injected and travel path of it is confirmed by taking x-rays.

Once the course is found as expected, the lumbar sympathetic ganglion block medication is injected and the spread is judged with the help of x-rays.

The injecting process of medicine takes only a few minutes, after which the needle is safely removed and a surgical tape is applied on the procedure area.

What Are The Side Effects of Lumbar Sympathetic Ganglion Block?

Possible Side Effects of Lumbar Sympathetic Block Include:

After the lumbar sympathetic ganglion block procedure, patient may be made to rest in the recovery room. All the vital signs like heart rate, blood pressure, temperature, pulse rate etc. would be monitored. Any necessary investigations will be done as per the procedure protocol.

There may be pain at the injection site and the legs may feel warm or numbness. This will eventually reduce and the patient can resume normal activities.

Warning Signs Post Procedure- Signs one should look for after the lumbar sympathetic ganglion block procedure and seek medical attention include-

Numbness and/or tingling that may last for more than 12 to 24 hours needs to be evaluated in order to rule out bleeding.

Signs of fever or infection lasting for more than 24 hours.

An increased pain after ganglion block procedure needs attention to rule out injury to the nerve.

In pre-diabetic or diabetic persons, augmented levels of blood sugar may be seen and needs to be investigated.

Conclusion:

Lumbar sympathetic ganglion block is commonly used to treat back pain, leg pain and sciatica in conditions that have not responded to other conservative treatments.

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