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

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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