A lumbar sympathectomy may be done in an attempt to increase the blood supply to the legs. This can help healing and improve pain. The lumbar sympathetic nerves are a group of nerves in your lower back that control the blood supply (circulation) to your legs.
Risks of this treatment
Your blood pressure may drop temporarily. This is likely to return to normal in 24 hours but you should take care when getting up from lying to sitting or standing as you may feel light headed. You may notice a feeling of warmth in your leg or legs.
Your back may feel sore. Up to 10% of patients get an annoying pain that travels into the groin. This usually gets better within about 6 weeks. As with any injection, there is a very slight chance of getting an infection where the needle is placed.
Every effort is made to avoid this with use of skin-cleaning solution, sterile gloves and equipment. Very rare complications include nerve damage and diarrhoea. There is a possibility of sexual problems (erection difficulties) in men having a lumbar sympathectomy on both sides. If you are sexually active you should discuss this with your pain doctor before the procedure.
The procedure is made as safe as possible by being performed by an experienced pain doctor who constantly monitors you throughout the procedure. You may discuss the risks further with your pain doctor.
Pre-operative assessment & Care
If you become pregnant, have any major illnesses/hospital admissions or start taking anticoagulant drugs (for example warfarin or clopidogrel) discuss this with the pain doctor before the procedure. If you have diabetes, you may need to make some changes to your diabetes medicine or diet on the day of the procedure. You should discuss this with your pain doctor before your procedure. On the day of the procedure: ·
- Follow the instructions given to you by the Day Surgical Unit staff about when last to eat or drink.
- Take all your usual medication including your painkillers
- Bring all your usual medication, or a list of what you are taking with you.
- Make sure that someone will collect you, take you home, and is available to stay with you overnight
During the procedure
At the Day Surgical Unit your pain doctor will see you and explain the procedure fully. You may be given medication (sedation) to make you feel sleepy during the injections. An oxygen mask will be placed over your face.
Before the procedure starts a small cannula (tube) will be placed in a vein in the back of your hand through which we can give you medicines and fluids if that becomes necessary. A needle will then be placed in your side at the level of your waist and some local anaesthetic given to numb the skin (this stings a little). Using an X-ray machine a needle will then be inserted so that the tip is close to the lumbar sympathetic nerves. A drug that affects the nerves is then injected. The procedure may be done on one side only, or on both sides.
The procedure takes about 30 minutes.
After the procedure your blood pressure, pulse and respiration rate may be checked. After the procedure – what to expect For some people the sympathectomy may not reduce their pain at all. It may make the pain worse and rarely it may create a new pain. You may feel weak or tired for a little while after the injection so we advise that you rest for 24 hours. During this time you should not: drive a car or operate equipment, sign any legal documents or drink alcohol.
You should continue taking your usual medication and the next day you may take a bath, or shower, and remove any plasters. Please contact your GP (family doctor) if you have any other symptoms causing you concern and if:
- There is unusual redness or swelling at the injection site
- Your temperature is 38° C (100.4 F) or greater
After discharge home
To get the best out of your lumbar sympathectomy you should: -Continue with your usual medication including your painkillers
- Generally keep active, but within your pain limits
- Re-introduce previously painful activities gradually over the next few weeks
- Maintain any exercise routine you may have been given by your physiotherapist You will either be given a follow-up appointment to attend the Pain Clinic after your procedure, or be followed up by telephone.
Whenever you come to the Pain Clinic, please bring all your usual medication or a list of what you are taking with you.
Telephone: 01256 377741
Fax: 01256 377665 Address: The Pain Team c/o The Hampshire Clinic Old Basing Hampshire RG24 7AL
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