Sympathetic Plexus Blocks

Introduction

Sympathetic plexus blocks are minimally invasive procedures targeting the sympathetic nervous system to provide pain relief for various conditions. These blocks involve injecting an anesthetic solution near the sympathetic nerves, which can help diagnose and treat pain originating from these nerves. Sympathetic plexus blocks are valuable for diagnosing and treating pain that is mediated by the sympathetic nervous system. They are particularly useful for conditions like CRPS, phantom limb pain, post-herpetic neuralgia, and hyperhidrosis. These blocks can provide significant pain relief and improve the quality of life for patients suffering from these conditions.

Stellate Ganglion Block

Indications: Used for pain in the head, neck, chest, and upper extremities, including conditions like complex regional pain syndrome (CRPS), phantom limb pain, and post-herpetic neuralgia.
Technique: The anesthetic is injected near the stellate ganglion, located in the neck area.
Goals: To provide pain relief and improve blood flow and sweating in the affected areas.
Medications Used: Local anesthetics like lidocaine or bupivacaine.
Duration of Effects: Relief can last from weeks to months.
Patient Experience: Patients may feel temporary warmth, numbness, or weakness in the affected area.
Side Effects/Complications: Temporary voice changes, eyelid droop, difficulty swallowing, and rare complications like infection or bleeding.

Lumbar Sympathetic Block

Indications: Used for pain in the lower extremities, including conditions like CRPS, phantom limb pain, and hyperhidrosis (excessive sweating).
Technique: The anesthetic is injected near the lumbar sympathetic ganglia, located in the lower back.
Goals: To provide pain relief, improve blood flow, and reduce excessive sweating.
Medications Used: Local anesthetics like lidocaine or bupivacaine, sometimes combined with corticosteroids.
Duration of Effects: Relief can last from weeks to months.
Patient Experience: Patients may feel temporary warmth, numbness, or weakness in the affected area.
Side Effects/Complications: Temporary soreness, infection, bleeding, and rare complications like nerve damage.

Celiac Plexus Block

Indications: Primarily used to manage chronic and severe abdominal pain caused by conditions like pancreatic cancer and chronic pancreatitis.
Technique: The procedure involves injecting medication directly into the celiac plexus, a network of nerves located behind the stomach. Imaging guidance (fluoroscopy or CT scans) is used to ensure accurate needle placement.
Goals: To block pain signals from the abdominal organs to the brain, providing relief from severe abdominal pain.
Medications: Local anesthetics (e.g., ropivacaine), corticosteroids (e.g., dexamethasone), and sometimes neurolytic agents like phenol or ethanol.
Effects: Pain relief typically begins within a few days and can last for several weeks or months.
Patient Experience: Patients may experience significant pain relief, reducing the need for oral pain medications.
Side Effects: Transient pain at the injection site, orthostatic hypotension, diarrhea, and in rare cases, lower extremity paralysis or multi-organ failure.

Superior Hypogastric Plexus Block

Indications: Used to manage chronic pelvic pain, including pain from conditions like ovarian, cervical, or uterine cancer, prostate cancer, and endometriosis.
Technique: The procedure involves injecting medication into the superior hypogastric plexus, located in front of the spine in the lower back. Imaging guidance is used to ensure accurate needle placement.
Goals: To block pain signals from the pelvic organs to the brain, providing relief from chronic pelvic pain.
Medications: Local anesthetics (e.g., bupivacaine) and sometimes corticosteroids4.
Effects: Pain relief can be immediate or may take a few days to be felt, and the duration of relief varies.
Patient Experience: Patients may experience significant pain relief, improving their quality of life.
Side Effects: Temporary drop in blood pressure, damage to nearby nerves or organs, bleeding, infection, and allergic reactions to the medications.

Ganglion Impar Block

Indications: Used to manage chronic pain in the perineal and tailbone area, including pain from conditions like cancer, chronic pelvic pain, and pain from surgery or radiation therapy.
Technique: The procedure involves injecting medication into the ganglion impar, located at the level of the coccyx (tailbone). Imaging guidance is used to ensure accurate needle placement.
Goals: To block pain signals from the perineal area to the brain, providing relief from chronic perineal pain.
Medications: Local anesthetics (e.g., lidocaine) and sometimes corticosteroids.
Effects: Pain relief can be immediate or may take a few days to be felt, and the duration of relief varies.
Patient Experience: Patients may experience significant pain relief, improving their quality of life.
Side Effects: Temporary pain at the injection site, bleeding, infection, and allergic reactions to the medications

We are here to help you

At the Institute of Interventional Pain Management, we are dedicated to helping patients with sympathetic-mediated pain by offering all types of sympathetic blocks. Our experienced team ensures that each procedure is performed with the utmost care and precision, providing relief and improving the quality of life for our patients.