What is a sympathetic block?
Sympathetic nerve block is the injection of a local anesthetic into a sympathetic ganglion to diagnose or treat pain disorders that involve the sympathetic nervous system.
The sympathetic nervous system is a linkage of nerves throughout the entire body. The nerves originate in the spinal cord and branch out to influence many bodily functions, such as blood pressure, urination, defecation, and sexual arousal. When the nerves are irritated or injured, the blood supply to your hands, feet, or other areas may be affected and can produce pain or sensory changes. Headaches, neck pain, and facial pain can also be seen in patients who have sympathetic nerve dysfunction.
Conditions treated by sympathetic block
Sympathetic nerve blocks are effective in relieving some chronic pain conditions. For example, complex regional pain syndrome has been shown to have excellent analgesia and alleviation of clinical pain symptoms after sympathetic blocks. Pain that originates from the sympathetic nervous system is not easily treated by oral pain medications, so sympathetic blocks are an extremely effective and beneficial treatment option.
How a sympathetic block works
A sympathetic nerve block involves injecting a local numbing anesthetic (lidocaine, bupivacaine) and a corticosteroid into the space where the sympathetic nerve ganglia are located. A local skin anesthetic is given first to numb the area and then another needle is inserted near the ganglion.
The entire procedure takes less than 15 minutes and X-ray guidance is used to ensure proper needle position. Sometimes your physician will recommend intravenous sedation to make the procedure more comfortable. Your physician will monitor you after the procedure to see what affects the block has on your pain.
Are there risks?
Due to the minimal amount of risk, sympathetic blocks are considered an appropriate and safe non-surgical treatment for many patients who suffer from pain. Complications of the ganglion block include infection, bleeding, pneumothorax (collapsed lung), nerve damage, and pharmacological complications related to the drugs utilized (Elias 2000).