Download Ganglion impar block injection GHPI1351_05_16_A4

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Patient
Information
Ganglion impar block injection
Introduction
This leaflet will provide you with information about the ganglion
impar block, the possible benefits and side effects and what
you should do afterwards.
What is a ganglion impar block?
Ganglion impar block is an injection into a group of nerve cells
located in front of the sacrum/coccyx joint at the base of your
back (tail bone). The injection consists of local anaesthetic with
or without steroid. Your consultant feels that it may reduce your
pain. It is used to improve the pain caused by irritated or
inflamed nerves in your lower back. The injection consists of
both steroid and local anaesthetic which both act towards
blocking the pain signals sent to the brain. The steroid also
reduces swelling and inflammation which can irritate the nerves
and cause the pain.
Where is it done?
Most of the procedures are carried out in the Chedworth Suite
at Cheltenham General Hospital. A small number of Dr Kafafy’s
patients will be asked to attend the Day Unit at Gloucestershire
Royal Hospital. A letter with details of your appointment and
instructions will be sent to you by the pain clinic.
On arrival
Reference No.
GHPI1351_05_16
Department
Pain Clinic
Review due
May 2019
• A doctor will discuss the procedure with you and ask you to
sign a consent form
• You may be asked to put on a hospital gown
• You will be asked to lie on the examination table on your
abdomen, with a pillow under your pelvis
• The skin around the area to be injected will be cleaned with
antiseptic. A local anaesthetic will be injected into your back
by your pain consultant to numb the area
• The site will be injected with local anaesthetic with or without
a steroid to the ganglion impar. You may feel some
discomfort whilst this procedure is being carried out but it is
important that you stay still during the procedure. If you
experience any pain, please tell a member of the team.
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Patient
Information
• X-ray pictures or an ultrasound is taken throughout the
procedure to ensure proper positioning
• Once completed a plaster will be placed over the injection
site. You will then be taken to the recovery area
• You will be observed for around 30 minutes after the
procedure.
How long will I be in hospital?
Although the procedure itself takes 15 to 20 minutes, you will
be given a time to come in for either a morning or afternoon
procedure. Due to the way the theatre lists are organised, you
may have a substantial wait before your injections are done, so
please come prepared for this. You will be offered a drink and a
biscuit and allowed home shortly afterwards.
Can I eat and drink?
You can eat and drink as usual, unless your pain consultants
advise you otherwise.
Can I take my usual tablets?
You should take all your regular medications except blood
thinning medication such as clopidogrel, warfarin or are diabetic
and on medication. You will receive specific instruction
regarding these medications in advance of the procedure. If this
applies to you please contact the Pain Clinic nurse using the
contact details below.
Can I drive home?
For safety reasons, you are asked not to drive home yourself
and to have someone available for the rest of the day.
Risks
• Some bruising or bleeding at the site of injection, particularly
if you take medication to thin your blood
• Small chance of an increase in pain, however this should
only last a few days
• Small chance of temporary leg weakness or numbness
• Small risk of damage to other local structures including
nerves, blood vessels and, very rarely underlying structures
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Patient
Information
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A very rare chance of a permanent increase in pain
Rare chance of infection or allergy to anything injected
Rare risk of bowel puncture
Rare risk of long-term worsening of pain
Anaphylaxis – severe allergic reaction to drugs
Unfortunately, no injection is without risk. In a very small
number of patients, there is a risk of damage to tissues in
the area of the injection and, very rarely, a permanent
increase in pain.
Will it work?
The ganglion impar block can be very effective, but does not
work for everyone. The benefits may be long or short term.
Your pain consultant thinks it is worth trying.
What happens next?
About 6 weeks after your procedure, either you will be asked to
telephone our clinical nurse specialists to give a progress
report, or your pain consultant will give you a form to post back
to us. Either way, the next step in your treatment will be
decided according to the amount of benefit you have had from
the injections and any further appointments will be sent to you
in the post. If you are free from pain, you may not be routinely
followed up, but may be left with a 6 month open appointment
instead.
Contact information
Pain Clinic team
Tel: 0300 422 2976
Monday/Wednesday/Friday, 9:00am to 12:00pm
Tuesday, 1:30pm to 4:00pm
An answering machine will be in operation at all other times.
Website: www.gloshospitals.nhs.uk/en/Wards-and
Departments/Departments/Pain-Management/Chroniclong
term-Pain-Service/
For urgent calls please contact your GP or NHS 111.
NHS111
Tel: 111
Content reviewed: May 2016
www.gloshospitals.nhs.uk