Ganglion impar block in patients with chronic coccydynia

Gonnade, Nitesh; Mehta, Neeraj; Khera, Pushpinder Singh; Kumar, Devesh; Rajagopal, Rengarajan; Sharma, Pramod Kumar

doi:10.4103/ijri.ijri_294_16

Cited by 30 publications

(36 citation statements)

References 9 publications

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“…24 In our study, a reduction in pain beginning at 1 hour and sustained for up to 6 months was provided by the GIB in both groups. This is consistent with the study by Gonnade et al 6 which reported a dramatic relief in pain starting at 1 hour after GIB and continuing for up to 6 months in 31 patients with chronic coccygodynia resistant to conservative treatment. Our study is different from theirs in terms of being retrospective and not assessing disability.…”

Section: Discussionsupporting

confidence: 93%

“…4 In recent years, trials suggest that ganglion impar block (GIB) can be used as a treatment option for chronic refractory coccygodynia and pelvic pain, including pain caused by malignant neoplasms. [5][6][7][8][9] The most important advantages of this technique are that it can be implemented at a wide range of ages, from adolescent to elderly patients, can improve quality of life, can provide an opportunity to apply recurrent injections in patients with partial pain relief, and can provide additional beneficial effect. 8,[10][11][12] Unfortunately, an acceptable symptomatic improvement cannot be achieved in approximately 18-25% of patients treated with GIB.…”

Section: Introductionmentioning

confidence: 99%

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The influence of coccygeal dynamic patterns on ganglion impar block treatment results in chronic coccygodynia

et al. 2018

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Objective Ganglion impar block (GIB) can be performed in patients with chronic coccygodynia who do not respond to conservative treatments. We investigated the effect of coccygeal dynamic patterns on the treatment outcome in patients with chronic coccygodynia treated with GIB. Materials and methods We retrospectively analyzed the data for patients diagnosed with chronic coccygodynia who underwent GIB only once by a transsacrococcygeal method under fluoroscopy guidance in our Pain Medicine Clinic. Patients were assessed with standard and dynamic coccyx radiographs and classified according to coccygeal mobility. Pain scores were assessed with a numerical rating scale (NRS) before and after the intervention (at 1 hour and 4, 12 and 24 weeks). A 50% or more reduction in the NRS score was accepted as significant pain relief. Results Of the 37 patients included in the study, 14 had normal coccyx (Group I) and 23 had immobile coccyx (Group II) based on the radiological evaluation. The NRS scores were significantly reduced in both groups on each follow-up visit but there was no significant difference between the two groups in terms of pre- and post-intervention NRS scores. Significant pain relief was achieved in 42.9% and 61.9% of patients in Group I and II at the last examination, respectively. Conclusion GIB administered by transsacrococcygeal method in patients with chronic coccygodynia is a safe and alternative treatment approach with reduced pain scores and low complication rates. In patients with chronic coccygodynia, having a normal or immobile coccyx does not appear to affect treatment outcomes.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

The influence of coccygeal dynamic patterns on ganglion impar block treatment results in chronic coccygodynia

et al. 2018

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“…In one of these studies carried out by Gunduz et al [9], a retrospective pilot study encompassing 22 chronic coccydynia patients on whom ganglion impar blockade was conducted via the transsacrococcygeal pathway, it was reported that there was a success rate of 82% after the first injection and relief from pain lasting, on average, for 6 months. In another recent study, Gonnade et al [20] prospectively examined 31 patients with chronic coccydynia on whom ganglion impar blockade had been carried out, and they evaluated their pain through the NRS and their functionality through the oswestry disability index (ODI) at 2, 4, 12, and 24 weeks [21]. The authors have reported a profound decrease in pain levels, a decrease in NRS scores, and noticeable positive results in the ODI [20].…”

Section: Discussionmentioning

confidence: 99%

“…In another recent study, Gonnade et al [20] prospectively examined 31 patients with chronic coccydynia on whom ganglion impar blockade had been carried out, and they evaluated their pain through the NRS and their functionality through the oswestry disability index (ODI) at 2, 4, 12, and 24 weeks [21]. The authors have reported a profound decrease in pain levels, a decrease in NRS scores, and noticeable positive results in the ODI [20]. Our study, in nature, supports the results of both studies, where additional steroids were administered in conjunction with local anesthetics for the purpose of ganglion impar blockade.…”

Section: Discussionmentioning

confidence: 99%

Are steroids required in the treatment of ganglion impar blockade in chronic coccydynia? a prospective double-blinded clinical trial

et al. 2019

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BackgroundGanglion impar blockade is a reliable and effective treatment option used in patients with coccydynia. Our primary objective was to specify the role of corticosteroids in impar blockade. We compared applications of local anesthetic with the local anesthetic + corticosteroid combination in terms of treatment efficiency in patients with chronic coccydynia.MethodsOur study was a prospective randomize double-blind study. The patients were divided into 2 groups after randomization. The first group (group SL) was made up of patients where a corticosteroid + local anesthetic were used during ganglion impar blockade. In the second group (group L) we used only local anesthetic. We evaluated numeric rating scale (NRS) and Beck depression scale, which were employed before the procedure and in 1st and 3rd months after the procedure.ResultsSeventy-three patients were included in the final analysis. We detected a significantly greater decrease in NRS values in the 1st month in group SL than in group L (P = 0.001). In the same way, NRS values in the 3rd month were significantly lower in the group with steroids (P = 0.0001). During the evaluation of the Beck test, we detected significantly greater decreases in the 1st month (P = 0.017) and 3rd month (P = 0.021) in the SL group than in the L group.ConclusionsGanglion impar blockade decreases pain in the treatment of chronic coccydynia and improve depression. Addition of steroids in a ganglion impar blockade is required for treatment response that should accumulate over a long period of time.

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“…We praise your journal and authors Gonnade et al , on the excellent recent publication titled, “Ganglion impar block in patients with chronic coccydynia.”[1] Their study of patients with chronic coccydynia (coccyx pain) showed that ganglion impar injections with local anesthetic block and corticosteroid significantly decreased pain and disability scores even at the maximum length of study follow-up, which was 6-month postinjection.…”

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confidence: 99%