![]() This is achieved through differential regulation of sympathetic outflow to a variety of organs. New Delhi: 2017.p.This review examines how the sympathetic nervous system plays a major role in the regulation of cardiovascular function over multiple time scales. Epidural drug administration lead to leaking of drug through neural foramen and bathing of sympathetic fibres hereby blocking sympathetic system.Ganglion impar block is used to alleviate pain arising from perineal region.Superior & inferior hypogastric plexus block can be used in cancer and non cancer chronic pelvic pain.T2-T3 Sympathetic block for upper limb CRPS and some types of thoracic pain.Celiac plexus block for upper abdominal malignancy and chronic benign pain.Sphenopalatine ganglion block for headache and facial pain.Splanchnic nerve block for malignant or benign upper abdominal pain.Stellate ganglion block and lumbar sympathetic block used for CRPS of upper and lower limbs.It does not result in sensory and motor loss as seen in somatic blockade.Įxamples of sympathetic blockade at various levels: Sympathetic blockade and its significance in pain management 5– Sympathetic blockade causes interruption in transmission by both efferent and afferent fibres. Modulation– It is said that sympathetic ganglia contain interneurons which have modulatory functions. So it will be a vague and non localised type of pain. Type of pain– As seen in anatomy,sympathetically mediated pain will not have dermatomal distribution. So during activation of sympathetic system like stress, painful stimuli are carried via afferents of somatic nerves. Sympathetically mediated neuropathic pain– If a somatic nerve gets damaged, it can lead to short circuits between damaged fibres and sympathetic system. Compression and damage at this site can cause sympathetic pain also. IDD– Pathophysiology of IDD is the sensitisation of sympathetic system at outer one third of annulus fibrosus.Ĭompression near foramen- After coming out of neural foramen, somatic and sympathetic fibres go in same path. But in certain conditions sympathetic nerves can carry painful sensations.Ĭauses of pain because of sympathetic nerves – Normally sympathetic system does not cause pain. The afferent fibres travel along the somatic nerves and blood vessels and enter sympathetic chain via grey rami communicants and leave via white rami communicants and join mixed spinal nerve 4. It means that many preganglionic fibres can go to one post ganglionic fibre and reverse. There is a concept of anatomical convergence and diversion with sympathetic system. Some fibres synapse with post ganglionic fibres at ganglions near to vertebral column and some near to viscera. Just after coming out of neural foramen, they pass through myelinated white rami communicants and join sympathetic trunk on anterolateral part of vertebral body. ![]() The sympathetic nerves pass along the somatic nerves in common path. The anatomy and distribution of sympathetic nerves and their supply is shown in figure below. Sympathetic supply consists of preganglionic and post ganglionic fibres with preganglionic fibres having cell bodies in lateral horn. Sympathetic fibres arise arise from thoracolumbar region of spinal cord i.e T1-L2 level. Sympathetic system is generally acted as a reaction which is called flight or fight reaction. It is different than somatic nervous system in many ways. So basically it is a complex set of neurons which help in mediation of internal homeostasis without conscious intervention or voluntary control. Sympathetic nervous system & pain Author: Himanshu Maratheĭefinition of Autonomic nervous system- It is defined as neurological substrate that acts to maintain homeostasis in the body 1.
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