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Page 1 of 3 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. www.gloshospitals.nhs.uk Page 2 of 3 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 www.gloshospitals.nhs.uk Page 3 of 3 Patient Information • • • • • • 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