{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:32:57Z","timestamp":1787841177939,"version":"build-2784847793"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2024,12,16]],"date-time":"2024-12-16T00:00:00Z","timestamp":1734307200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,4]]},"abstract":"Abstract<\/jats:title>\n \n Background and Aims:<\/jats:title>\n Chronic perineal pain (CPP) is the anorectal and perineal pain without underlying organic disease. The prevalence of CPP is 6\u201318%. The etiology for CPP may be idiopathic, benign, or malignant. We compared radiofrequency thermocoagulation of ganglion Impar with block using a combination of local anaesthetic and steroid for management of chronic perineal pain, with respect to pain relief, patients\u2019 self-reported belief about the efficacy of treatment, and side effects or complications, if any.<\/jats:p>\n <\/jats:sec>\n \n Material and Methods:<\/jats:title>\n Forty patients attending the Pain Management Centre of either sex in the age group of 20\u201370 years with history, physical examination, and pain patterns consistent with chronic perineal pain, who had been investigated to rule out malignancy and failed to respond to 6 weeks of conservative treatment with a combination of analgesics, anti-inflammatory drugs, neuromodulators, and physiotherapy, were enrolled in the study. The patients were randomly divided into two groups of 20 each using a computer-generated randomization number table. Group-I (n = 20): Patients were administered ganglion Impar block using a drug mixture comprising of 8 ml of 0.25% bupivacaine plus 80 mg of triamcinolone acetate under fluoroscopic guidance. Group II (n = 20): Patients received conventional radiofrequency thermocoagulation of ganglion Impar at 80 degree Celsius for 90 seconds under fluoroscopic guidance. Outcome assessment was done after minimally invasive pain and spine intervention (MIPSI) with evaluation of pain using the Numeric Rating Scale (0\u201310), patients\u2019 self-reported belief about the efficacy of treatment using Patient Global Impression of Change (PGI-C), and side effects or complications, if any.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n The majority of the patients in our study were in the age group of 40\u201350 years, and 80% of the patients were females and weighed 60\u201370 kg. The majority of the patients in our study had history of trauma, which led to coccygodynia. There was statistically and clinically significant improvement in pain score after ganglion Impar block in both the groups at all time intervals during the study period (\n P<\/jats:italic>\n < 0.05). Patients\u2019 self-reported belief about efficacy as per PGI-C was clinically and statistically better in group II as compared to group I at all time intervals throughout the study period (\n P<\/jats:italic>\n < 0.005). Four patients in group I required second ganglion Impar block during the 12 months study period. The most common side effect was temporary pain on injection.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n Both the techniques of MIPSI, that is, fluoroscope-guided ganglion Impar block using corticosteroid and local anaesthetic and radiofrequency thermocoagulation, are effective and provide good pain relief to the symptomatic patients. With respect to improvement in pain relief and patients\u2019 self-reported belief about the efficacy of treatment and side effects or complications, fluoroscope-guided ganglion Impar radiofrequency thermocoagulation is better as compared to fluoroscope-guided ganglion Impar block using corticosteroids and local anesthetics.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/joacp.joacp_40_24","type":"journal-article","created":{"date-parts":[[2024,12,16]],"date-time":"2024-12-16T05:01:01Z","timestamp":1734325261000},"page":"280-285","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Comparison of radiofrequency thermocoagulation of ganglion Impar with block using a combination of local anaesthetic and steroid in chronic perineal pain"],"prefix":"10.4103","volume":"41","author":[{"given":"Naveen","family":"Malhotra","sequence":"first","affiliation":[{"name":"Department of Cardiac Anaesthesia and Pain Management Centre, Rohtak, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaishali","family":"Phogat","sequence":"additional","affiliation":[{"name":"Department of Cardiac Anaesthesia and Pain Management Centre, Rohtak, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neha","family":"Sinha","sequence":"additional","affiliation":[{"name":"Department of Cardiac Anaesthesia and Pain Management Centre, Rohtak, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Cardiac Anaesthesia and Pain Management Centre, Rohtak, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N","family":"Charan","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Pt. B. D. Sharma PGIMS, Rohtak, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"family":"Arun","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Pt. B. D. Sharma PGIMS, Rohtak, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,12,16]]},"reference":[{"key":"R1-20250324","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1097\/MEG.0b013e32834164f6","article-title":"Chronic perineal pain: Current pathophysiological aspects, diagnostic approaches and treatment","volume":"23","author":"Andromanakos","year":"2011","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"R2-20250324","doi-asserted-by":"crossref","first-page":"661","DOI":"10.36076\/ppj.2007\/10\/661","article-title":"Trans-sacrococcygeal approach to ganglion Impar block for management of chronic perineal pain: A prospective observational study","volume":"10","author":"Toshniwal","year":"2007","journal-title":"Pain Physician"},{"key":"R3-20250324","first-page":"15746","article-title":"The efficacy and safety of the ganglion Impar block in chronic intractable pelvic and\/or perineal pain: A systematic review and meta-analysis","volume":"9","author":"Li","year":"2016","journal-title":"Int J Clin Exp Med"},{"key":"R4-20250324","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1111\/j.1533-2500.2005.05206.x","article-title":"Thermocoagulation of the ganglion Impar or ganglion of Walther: Description of a modified approach. preliminary results in chronic, non-oncological pain","volume":"5","author":"Reig","year":"2005","journal-title":"Pain Pract"},{"key":"R5-20250324","first-page":"823","article-title":"Repeated ganglion Impar block in a cohort of 83 patients with chronic pelvic and perineal pain","volume":"20","author":"Le","year":"2017","journal-title":"Pain Physician"},{"key":"R6-20250324","first-page":"328","article-title":"Radiofrequency thermocoagulation of ganglion Impar in the management of coccydynia: Preliminary results","volume":"20","author":"Demircay","year":"2010","journal-title":"Turkish Neurosurg"},{"key":"R7-20250324","first-page":"1","article-title":"Conventional radiofrequency thermocoagulation vs pulsed radiofrequency neuromodulation of ganglion Impar in chronic perineal pain of nononcological origin","volume":"18","author":"Usmani","year":"2017","journal-title":"Pain Med"},{"key":"R8-20250324","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.2147\/JPR.S105506","article-title":"Trans-sacrococcygeal approach to ganglion Impar: Radiofrequency application for the treatment of chronic intractable coccydynia","volume":"9","author":"Adas","year":"2016","journal-title":"J Pain Res"},{"key":"R9-20250324","doi-asserted-by":"crossref","first-page":"24","DOI":"10.5005\/jp-journals-10046-0159","article-title":"Ganglion Impar block and neurolysis for chronic pain: A review","volume":"6","author":"Gupta","year":"2020","journal-title":"J Recent Adv 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Med"},{"key":"R13-20250324","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1097\/00000542-200610000-00048","article-title":"An alternative approach to ganglion Impar neurolysis under computed tomography guidance for recurrent vulva cancer","volume":"105","author":"Ho","year":"2006","journal-title":"Anesthesiology"},{"key":"R14-20250324","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1016\/j.spinee.2003.07.011","article-title":"A treatment and outcomes analysis of patients with coccydynia","volume":"4","author":"Hodges","year":"2004","journal-title":"Spine"},{"key":"R15-20250324","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.crad.2009.08.007","article-title":"CT-guided injection for ganglion Impar blockade: A radiological approach to the management of coccydynia","volume":"65","author":"Datir","year":"2010","journal-title":"Clin Radiol"},{"key":"R16-20250324","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1097\/01.anes.0000265174.90619.80","article-title":"Ganglion Impar injection techniques for coccydynia (coccyx pain) and pelvic pain","volume":"106","author":"Foye","year":"2007","journal-title":"Anesthesiology"},{"key":"R17-20250324","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1002\/ca.22193","article-title":"One is the loneliest number: A review of the ganglion Impar and its relation to pelvic pain syndromes","volume":"26","author":"Walters","year":"2013","journal-title":"Clin Anat"},{"key":"R18-20250324","first-page":"554","article-title":"Coccygodynia","volume":"10","author":"Patjin","year":"2010","journal-title":"Pain Pract"}],"container-title":["Journal of Anaesthesiology Clinical 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