No abstract

Perineal pain is a complex clinical condition causing significant functional impairment and frustration to the patient. The diversity of presentation and etiologies poses a challenge to the treating physician. Ganglion Impar is a solitary retroperitoneal structure in front of sacrococcygeal junction behind the rectum. It provides nociceptive and sympathetic supply to the perineal structures. Interventional pain management in the form of fluoroscopy guided Ganglion Impar block has been shown to benefit in patients with perineal pain. Here we describe a case series of Ganglion Impar block in four patients with various etiologies analysing its safety and efficacy. In this case series, four patients visiting the pain clinic in a tertiary care hospital with complaints of perineal pain of various etiologies were included. All the patients were given Ganglion Impar block under fluoroscopy guidance. NRS was assessed before the block, immediately after the block, and at time intervals of three months, six months, and one year post block. Any complications during the procedure and the follow up period were noted. All four patients had very good pain relief after block. The mean NRS value before the block was 8 ± 0.701. Ten minutes after the procedure, mean NRS value was 2.75 ± 0.95. NRS scores at three months, six months and one year follow-up intervals were 1.5 ± 1.29, 1.25 ± 1.25, and 1 ± 1.41 which is statistically significant. There were no complications. Fluoroscopy guided Ganglion Impar Block is a safe and effective intervention in the management of acute and chronic perineal pain of various etiologies providing good pain relief.