Expert: Dr Ian Jackson - please note UK based - 2/28/2008

Question
I have had chronic pelvic pain for the past three years and have been
diagnosed with pelvic congestion and interstitial cystitis.  Pain medications
seem to have no effect on me, I believe I have tried just about everything.  A
couple weeks ago I had a sympathetic nerve block, and could not believe how
incredibly painful the procedure was.  They gave me a double dose of
whatever it was that they put in the IV, and I was still in more pain than I have
ever experienced.  Even after the procedure, and after an injection of
morphine, I was still in terrible pain.  My question is, should the procedure
be that painful?  Also, is there anything that can be done to make the
procedure less painful for me?  I am supposed to have another block in a
couple weeks, and I don't know if I can go through that amount of pain again.  
I appreciate any information you can give on this matter.  Thanks in advance.

Answer
Hi Sara
The amount of pain that is felt during this procedure is very variable - some people are very lucky and only experience a degree of discomfort whilst others require strong pain killers as you did.
The amount of discomfort felt can vary between procedures as well for various reasons. They can use morphine and other pain killers to help and it is possible these days to give an infusion of a very powerful but short acting pain killer called remifentanil. However this does depend on the setup where the procedure is being performed and the background of those doing thew procedure. You need to discuss your concerns with your chronic pain specialist (as soon as possible) who is doing this procedure and discuss with him/her if there is anything they can offer.
I hope everything works out for you.
Dr Ian Jackson