The Ganglion Impar Block can be used both as a diagnostic and therapeutic tool in patients suffering from pain in the
perineum, distal rectum and anus, vulva, and distal third of the vagina.
The technique can be performed with local anesthetic and steroid for nonmalignant pain conditions, such as coccygodynia, or
perirectal pain from tumor involvement. Neurolytic blockade should probably only be performed for malignant pain conditions,
and only after a diagnostic block is performed. The advantage of the Ganglion Impar block over other neurolytic procedures
for rectal pain is that bowel and bladder function is generally unaffected. However, this should be confirmed first with the local
anesthetic block.
The patient will be placed in the prone position and the target area near the tail bone will be identified using live X-ray. After
numbing the skin, a needle will be advanced to the desired area under fluoroscopic guidance. Prior to injection of the Local
Anesthetics, the correct position of the needle will be verified using contrast solution.
The procedure may take between 20-30 minutes to be performed. After completion of the procedure, Band-Aids may be
applied to the needle sites. A nurse will monitor the blood pressure and pulse, and then review the discharge instructions with
the patient before going home on the same day.
