Autonomic Nerve Blocks

Abstract

Chronic pain disorders present with different etiologies and consequently their signals are carried by different classifications of nerve fibers. Syndromes and disorders that present with sympathetically based pain are therefore treated differently than those with more musculoskeletal based etiologies. Autonomic nerve blockade primarily targeting sympathetic nerve ganglia can be used to provide significant pain relief in certain chronic pain disorders, most notably complex regional pain syndrome. Commonly targeted sympathetic ganglia include the stellate, celiac, and lumbar sympathetic chains. The purpose of this chapter is to provide recommendations on how to best perform these blocks as well as describe their indications, possible complications, and relevant surrounding anatomy.