Sympathetic Ganglion Blocks in the Elderly: Efficacy, Safety, Analgesic Consumption, and Complications

Year 2026, Volume: 16 Issue: 1, 96 - 102, 19.03.2026

Ahmet Başarı , Hanzade Aybüke Ünal-Özer , Güngör Enver Özgencil , İbrahim Aşık

https://izlik.org/JA98JZ22UN

Abstract

Aim: Chronic pain management is crucial in geriatric pain management.
Sympathetic ganglion blocks are minimally invasive procedures
performed in pain conditions associated with the sympathetic
system, such as cancer-related, ischemic, and neuropathic
pain. Data regarding the effectiveness and safety of these blocks
in elderly patients are limited. This study evaluates the effects of
sympathetic ganglion blocks on pain intensity, opioid consumption,
and complications.
Materials and Methods: This retrospective cohort study included
417 patients aged ≥65 years who underwent a sympathetic ganglion
block. Procedures included stellate, thoracic and lumbar
sympathetic, celiac, splanchnic, hypogastric, and impar ganglion
blocks. Pain intensity was assessed using the Visual Analog Scale
(VAS), and opioid use was converted to morphine equivalents.
Complications were classified as minor or major.
Results: Visual analog scale scores significantly decreased from
7.88±0.89 at baseline to 3.98±1.30 at 1 month and 5.76±1.51
at 3 months (p <0.001). Daily opioid consumption was reduced
from 90.38±99.45 mg/day to 36.39±33.36 mg/day at 3 months
(p <0.001), with the most pronounced decrease in malignant patients.
Complications were observed in 35% of patients, primarily
minor (e.g., orthostatic hypotension, Horner syndrome), while major
complications were rare (e.g., pneumothorax).
Conclusion: Sympathetic ganglion blocks effectively reduce pain
and opioid use in elderly patients with chronic pain of malignant
and nonmalignant origins. Although complication rates are noteworthy,
safety can be ensured with careful patient selection and
follow-up.

Keywords

Analgesic Agents , Pain , Chronic , Elderly , Postoperative Complications , Sympathetic Ganglion , Blocks

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