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EP084 An effective and safe procedure for anococcygeal pain syndrome: Combination of ganglion impar block and caudal epidural steroid injection
  1. Fatemeh Farham1,
  2. Gözde Celik1,
  3. Aslihan Gülec Kilic2 and
  4. Nurten İnan1
  1. 1Algology, Gazi University Hospital, Ankara, Turkey
  2. 2Anesthesiology and Reanimation, Gazi University Hospital, Ankara, Turkey


Application for ESRA Abstract Prizes: I apply as an Anesthesiologist (Aged 35 years old or less)

Background and Aims We aimed to evaluate pain scores after ganglion impar block and caudal epidural steroid injection in patients with chronic anococcygeal pain syndrome, who did not respond to conservative treatment.

Methods The information of 31 patients with anococcygeal pain, who underwent Ganglion impar block and caudal epidural steroid injection was retrospectively reviewed. G.impar block (6mL of bupivacaine%0.125+methylprednisolone 40mg mixture) and caudal steroid injection (7mL of bupivacaine%0.125 +methylprednisolone 40mg mixture) were applied to all patients. After one month, G. impar pulsed radiofrequency(pRF) (6minutes at 42degrees) and caudal injection (7mL of bupivacaine%0.125+methylprednisolone 40mg mixture) were applied to patients who temporarily benefited from the procedure. All procedures were performed under fluoroscopy. Demographic data, etiology of pain, and visual analog scale(VAS) scores before and after the procedure were obtained from patient records.

Results A total of 31 patients of which 5 males(16%) and 26 females(84%) were included in the study. Average age was 41.5 years. Etiology was trauma in 20 patients, surgery in 2 patients, gastrointestinal disease in 2 patients, vaginal delivery in 1 patient, and idiopathic in 5 patients.The mean score of the VAS before the procedure was 7.74. After Impar and caudal block with pRF, average VAS score was decreased to 1.48. 21 patients became pain- free after the procedure, which remained for an average of 52.4 days (2-1840 days). 2 patients reported transient paresthesia and 1 patient reported transient distal edema after the procedure.

Conclusions G.İmpar block,pRF and caudal epidural steroid injection are effective procedures for patients with anococcygeal pain without significant complications.

  • chronic pain
  • coccyx
  • ganglion impar block
  • sympathetic nerve block

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