J Korean Pain Soc.  1997 Nov;10(2):250-253.

The Effect of Ganglion Impar Block for Neoplastic Perineal Pain with Coccygeal Fracture

• Lee SK
• Cha YD
• Suk MH

Abstract

The perineum is comprised of diverse anatomic structures with mixed sympathetic and somatic in- nervation. The coccyx is innervated by the coccygeal nerves and branches of the fifth sacral root. Recently, ganglion impar block has been introduced as an alternative means of managing intractable pain of sympathetic origin, coccygodynia by trauma, tenesmus and perineal hyperhydrosis. We managed a 59-year-old female patient who had suffered from perineal pain by metastasis of cervical cancer. Approach to impar ganglion through the anococcygeal ligament was impossible because her coccyx was hyperflexed anteriorly by old fracture. But we could perform ganglion impar block successfully by approach through the separation of sacrum and coccyx.

Keyword

Anaesthetic technique, regional; Ganglion impar block; Anatomy; Anococcygeal ligament; Separation of sacrum and coccyx

MeSH Terms

Coccyx
Female
Ganglion Cysts*
Humans
Ligaments
Middle Aged
Neoplasm Metastasis
Pain, Intractable
Perineum
Sacrum
Uterine Cervical Neoplasms