Ganglion Impar Injection for Relief of Refractory Anorectal Pain in Multiple Sclerosis Patients

Thomas Ng, MD, Anjana Sekaran, Alopi Patel
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Abstract

Background: Pelvic, perineal, and anorectal pain can be common findings in patients with Multiple Sclerosis (MS). These patients can develop bowel and bladder dysfunction with disease progression, as well as musculoskeletal component of their pain. The ganglion impar injection and radiofrequency ablation procedure are well-documented interventions to treat visceral pain arising from the pelvis as well as nociceptive pain from the anus and rectum. Case Report: We discuss the cases of two MS patients with significant disease progression who present with anorectal pain refractory to medical and surgical treatment. The ganglion impar block was offered to both of these patients with significant pain relief reported immediately and after several weeks. Conclusion: Ganglion impar block and radiofrequency ablation are safe and effective interventions for pelvic and perineal pain and can be beneficial for severe refractory anorectal pain in MS patients. Key words: Rectal pain, pelvic pain, perineal pain, Multiple Sclerosis, ganglion impar, interventional pain, radiofrequency ablation
神经节阻滞注射液缓解多发性硬化症患者难治性肛肠疼痛
背景:盆腔、会阴和肛门直肠疼痛是多发性硬化症(MS)患者的常见症状。这些患者可随着疾病进展而出现肠道和膀胱功能障碍,以及疼痛的肌肉骨骼部分。神经节注入和射频消融术是治疗骨盆内脏疼痛以及肛门和直肠痛觉性疼痛的有效干预措施。病例报告:我们讨论的情况下,两名多发性硬化症患者的疾病进展显著谁目前的肛门直肠疼痛难治性药物和手术治疗。这两名患者均接受神经节阻滞治疗,几周后和几周后均有明显的疼痛缓解。结论:神经节阻滞和射频消融是治疗盆腔和会阴疼痛的安全有效的干预措施,对MS患者严重难治性肛肠疼痛是有益的。关键词:直肠疼痛,盆腔疼痛,会阴疼痛,多发性硬化症,神经节障碍,介入性疼痛,射频消融
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