Korean J Pain.  2019 Oct;32(4):301-306. 10.3344/kjp.2019.32.4.301.

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

Affiliations
  • 1Division of Pain Medicine, Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Marmara University, Istanbul, Turkey. dripeks@yahoo.com
  • 2Department of Physical Medicine and Rehabilitation, Kayseri City Hospital, Kayseri, Turkey.
  • 3Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Marmara University, Istanbul, Turkey.

Abstract

BACKGROUND
Ganglion 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.
METHODS
Our 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.
RESULTS
Seventy-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.
CONCLUSIONS
Ganglion 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.

Keyword

Adrenal Cortex Hormones; Anesthetics, Local; Beck Test; Coccygeal Pain; Depression; Ganglion Impar Blockade; Pain; Rating Scale

MeSH Terms

Adrenal Cortex Hormones
Anesthetics, Local
Depression
Double-Blind Method
Ganglion Cysts*
Humans
Prospective Studies*
Random Allocation
Steroids*
Adrenal Cortex Hormones
Anesthetics, Local
Steroids

Figure

  • Fig. 1 Flow diagram.


Cited by  3 articles

Steroids further improve ganglion impar blocks for coccyx pain (tailbone pain)
Patrick M. Foye, Marielle R Araujo, Gurbind Jussa S Sidhu
Korean J Pain. 2020;33(4):400-401.    doi: 10.3344/kjp.2020.33.4.400.

Author’s reply
Savas Sencan, Ipek Saadet Edipoglu, Fatma Gul Ulku Demir, Gunay Yolcu, Osman Hakan Gunduz
Korean J Pain. 2020;33(4):401-402.    doi: 10.3344/kjp.2020.33.4.401.

Comparison of treatment outcomes in chronic coccygodynia patients treated with ganglion impar blockade versus caudal epidural steroid injection: a prospective randomized comparison study
Savas Sencan, Gunay Yolcu, Serhad Bilim, Ozge Kenis-Coskun, Osman Hakan Gunduz
Korean J Pain. 2022;35(1):106-113.    doi: 10.3344/kjp.2022.35.1.106.


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