98 - Lumbar Sympathetic Ganglion Block

Abstract

Lumbar sympathetic ganglion block is useful in the evaluation and management of sympathetically mediated pain of the kidneys, ureters, genitalia, and lower extremities. Included in this category are phantom limb pain, reflex sympathetic dystrophy, causalgia, and a variety of peripheral neuropathies. Lumbar sympathetic ganglion block also is useful to manage pain caused by vascular insufficiency of the lower extremity, including pain secondary to frostbite, atherosclerosis, Buerger disease, and arteritis associated with collagen vascular disease, and to maximize blood flow after vascular procedures on the lower extremities. Lumbar sympathetic ganglion block with local anesthetic can be used as a diagnostic tool when differential neural blockade is performed on an anatomic basis in the evaluation of flank, pelvis, and lower extremity pain. If destruction of the lumbar sympathetic chain is being considered, this technique can be used in a prognostic manner to indicate the degree of pain relief that the patient may experience. Lumbar sympathetic ganglion block with local anesthetic also is useful in the treatment of acute herpes zoster and postherpetic neuralgia involving the lumbar and sacral dermatomes. Clinical reports suggest that lumbar sympathetic block may provide palliation of the pain associated with interstitial cystitis. Destruction of the lumbar sympathetic chain is indicated for the palliation of pain syndromes that have responded to lumbar sympathetic blockade with local anesthetic.