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Continuous Inferior Mesenteric Ganglion Block for the Control of Abdominal Pain
  1. Young K. Choi, M.D., F.A.C.P.M. and
  2. Emidio Novembre, D.O.
  1. From the Department of Anesthesia, New Jersey Pain Institute, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, New Jersey.
  1. Reprint requests: Young K. Choi, M.D., F.A.C.P.M., Director, New Jersey Pain Institute, Department of Anesthesia, UMDNJ-Robert Wood Johnson Medical School, 125 Paterson Street, Suite 6100, New Brunswick, NJ 08901.


Background and Objectives. A 71-year-old woman was referred for control of intractable left-sided abdominal pain and constipation caused by stage 2B rectosigmoid colon cancer. She was treated with an intravenous morphine sulfate infusion at 4 mg/h which made her drowsy and lethargic. Because the distal colon is innervated by the inferior mesenteric sympathetic ganglion, it was hypothesized that a continuous block of this ganglion would provide both pain control and increased intestinal motility.

Methods. The patient was placed in a prone position, and a Tuohy needle was placed at an entry site 7 cm lateral to the L3 spinous process. The needle was advanced 2 cm anterior to the L3 vertebral body with fluoroscopic guidance. An 18-gauge indwelling catheter was placed through the needle and a continuous infusion with 0.1% bupivacaine was maintained for 4 days.

Results. The patient obtained immediate pain relief and bowel motility. She remained awake and comfortable throughout the duration of therapy. She was discharged home 3 days after stopping the infusion and required a minimal amount of opioids.

Conclusion. Continuous inferior mesenteric ganglion block may be an option in providing relief for pain caused by distal colon pathology.

  • sympathetic block
  • inferior mesenteric ganglion
  • continuous infusion
  • chronic pain
  • colon cancer.

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