Pain: ganglion impar block: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Pain: ganglion impar block

Sample item

A patient with rectal cancer has intractable perineal pain with a burning, poorly localised quality. Which block targets the sympathetic ganglion for this pain?

AStellate ganglion blockBCoeliac plexus blockCLumbar plexus blockDGanglion impar block

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Ganglion impar block

The ganglion impar (ganglion of Walther) is the terminal fusion of the sympathetic chains at the sacrococcygeal junction. Blockade or neurolysis treats sympathetically mediated perineal, rectal and genital pain. It is used for cancer-related and chronic perineal pain.

Option by option

A. Stellate ganglion block
The stellate ganglion block treats pain in the head, neck and upper limb.
B. Coeliac plexus block
The coeliac plexus block treats upper abdominal visceral pain.
C. Lumbar plexus block
The lumbar plexus block is used for hip and thigh analgesia.
D. Ganglion impar block (correct)
Correct. The ganglion impar supplies sympathetic fibres to the perineum.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is D, Ganglion impar block. The ganglion impar (ganglion of Walther) is the terminal fusion of the sympathetic chains at the sacrococcygeal junction.

Why is "Stellate ganglion block" not the answer?

The stellate ganglion block treats pain in the head, neck and upper limb.

Why is "Coeliac plexus block" not the answer?

The coeliac plexus block treats upper abdominal visceral pain.

Why is "Lumbar plexus block" not the answer?

The lumbar plexus block is used for hip and thigh analgesia.

What concept does this question test?

It tests Pain: ganglion impar block in Anaesthesia. Blockade or neurolysis treats sympathetically mediated perineal, rectal and genital pain. It is used for cancer-related and chronic perineal pain.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Pain: ganglion impar block?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.