Pain Management
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 Ganglion Impar Block
--  A ganglion impar block is a procedure used to reduce the symptoms of tailbone pain(coccycodyenia),chronic pelvic or rectal pain by blocking nerve impulses. The ganglion impar is a structure located at the level of the coccyx. 
The nerve block can be diagnostic or therapeutic. One of three things will happen: 
1. The pain does not go away, which means that it is probably not coming from the nerves at the site of the injection. This is of diagnostic value.
2. The pain goes away and stays away for a few hours, but then returns. In this case, the block is also of diagnostic value, as it means the pain is probably coming from the nerves at the level of the injection, but the steroid was of no benefit.
3. The pain goes away after the block but returns later that day and then improves over the next few days. This means that the block was of therapeutic value, as both the anesthetic agent and the steroid had an effect on the pain.
If you experience some benefit from the injection, it may be repeated. 
3. What happens during the procedure?
Once in the procedure room, our nursing staff will position you on your stomach on a narrow table. Your back will be cleaned with iodine and sterilely draped. The doctor will numb your skin with a small needle, which will sting just a bit. It is very important to hold still and let us know if we are causing you discomfort. Next, the doctor will use an X-ray machine (fluoroscope) to guide the needle into the correct spot. An X-ray contrast (dye) may be injected at this point to confirm that the needle has been positioned correctly. Please let the doctor know if you have an allergy to dye. Local anesthetic and steroid are then injected through the needle, and the needle is removed. Your skin will be cleaned and a Band-Aid may be applied. The Band-Aid may be removed the next morning. The procedure should take 10 to 15 minutes. 
Your pain may improve immediately after the injection due to the local anesthetic. It is important to keep track of how you feel for the remainder of the day. The steroid usually takes two or three days to have an effect in most people and peaks in about two weeks. 
4. What happens after the procedure?
After the procedure, you will go to the ambulatory recovery area. You will remain there for one hour before being discharged home. You may have some local tenderness from the needles, which ice may help relieve. You may also resume all of your medications, including those you take for pain.