Lumbar Sympathetic Nerve Block (including Celiac Plexus Block and Ganglion Impar Block)
Your body has special nerves known as sympathetic nerves in your back which ,control blood supply and sweating to your legs and feet . These nerves can be anesthetized to change the blood flow to a limb and to decrease the pain which is mediated by these sympathetic nerves:
The Lumbar Sympathetic Nerve Block is a procedure used to block or decrease pain in the lower extremities caused by injury or disease of the sympathetic nervous system. The lumbar sympathetic nerves are located on either side of the lumbar spine (lower back).
After an injury or illness, the sympathetic nervous system may not function properly, causing pain. Some of the more common conditions include Complex Regional Pain Syndrome (CRPS) also known as Reflex Sympathetic Dystrophy, Sympathetic Maintained Pain and Herpes Zoster (shingles) involving the lower part of the body.
If the block relieves your pain, the doctor will then perform a series of blocks at a another time, in an attempt to break the pain cycle and provide long lasting pain relief. The number of blocks you will need depends on how long the pain relief lasted between injections. Usually you will get more and longer pain relief after each injection. If the series of blocks do not relieve your pain, a radiofrequency lesion may be done, or consideration of stimulator implant may be necessary.
The Lumbar Sympathetic Block is an outpatient procedure, usually done in the Operating Room or a Special Procedure Room. For your safety and comfort, you will be connected to monitoring equipment (EKG monitor, blood pressure cuff, and a blood-oxygen monitoring device), and positioned on your stomach. The doctor or nurse may start an intravenous line and give some medicine to help you relax. Your back is cleansed with an antiseptic soap after which the doctor injects numbing medicine deep into your skin and tissue. This will cause a burning sensation for a few seconds. After the numbing medicine takes effect, the doctor will insert a another needle and, with the assistance of a special X-ray machine called a fluoroscope, inject a radiopaque dye (contrast solution) to ensure the needle is in proper position. With the needle in position, a small mixture of numbing medicine (anesthetic) and anti-inflammatory medicine (steroid) is injected.
After the procedure, we ask that you remain at the Clinic until the doctor feels you are ready to leave.
It is not necessary for you to go to sleep for this procedure; however, you will receive enough medication to keep you comfortable.
Normally, a lumbar sympathetic block procedure takes no more than 10 or 15 minutes.
The risks, although infrequent, include: