Lumbar Sympathetic Ganglion Block
Lumbar Sympathetic Ganglion Block is an interventional pain in the neck process . Procedure is performed to achieve long term botheration relief of 4 to 6 months or longer .
Ganglion Block is indicated for follow diseases
Procedure :
Ganglion Block is performed by interventional pain specializer . Procedure is performed under mild to restrained sedations . Patient is advised to lie in prostrate position on X - beam compatible operative table . ‘ Flex prostrate position ’ is preserve by placing pillow under abdomen . Patient if ineffectual to allow ‘ Flex prone position ’ then procedure is performed in curl sidelong position .
Skin Preparation : operative area of lumbar vertebra 2,3 and 4 is identified by using X - electron beam image . Skin area where acerate leaf will be penetrate is brand with marking penitentiary . The tegument is prepped with antiseptic solution as suggested by surgical sum and joint commission .
numb of Skin and hypodermic tissue : The skin field that was marked for acerate leaf penetration is anesthetized to numb with a local anesthetic . Local anesthetics used are Xylocaine 0.5 % or 1 % .
Needle Placement : Lumbar sympathetic ganglions are located over antero - sidelong surface of vertebral bodies of L2,3 and 4 lumbar vertebra . All three or 2 ganglion may be block depending on meter reading for routine . Lumbar vertebra 2 , 3 and 4 are identify using X - irradiation . Marking pen is used to punctuate entry point of needle about 3 - in lateral from midline at the level of L2 , 3 and or 4th lumbar vertebrae . After local anesthesia 22 G spinal anesthesia is localise near anterolateral surface of body of lumbar vertebra under fluoroscopic direction . Needle location is confirmed with fluoroscopy using oblique , sidelong and antero - posterior view . Dye is shoot and linear spread of dye in cephalic and caudal direction is confirmed using fluoroscopy in different plane . Local anesthesia Xylocaine is injected as a test dose , if needle baksheesh is in blood vessel then phonograph needle is repositioned . Dye study may want to be repeat . Once needle point is confirm at right place then medicament are injected in volume of 4 to 6 cc at each level . Procedure may take 30 to 45 proceedings .
