Pain: lumbar sympathetic 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: lumbar sympathetic block

Sample item

A patient with severe peripheral vascular disease has ischaemic rest pain in the foot and is unfit for revascularisation. Which block may improve pain and perfusion?

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

The answer and the reasoning

B. Lumbar sympathetic block

Lumbar sympathetic blockade causes vasodilation in the lower limb by interrupting sympathetic outflow, improving skin blood flow and relieving ischaemic and sympathetically maintained pain. It is also used in CRPS of the lower limb. The stellate ganglion block serves the upper limb and head.

Option by option

  • A. Coeliac plexus block

    The coeliac plexus supplies upper abdominal viscera.

  • B. Lumbar sympathetic block (correct)

    Correct. The lumbar sympathetic chain supplies vasomotor tone to the leg.

  • C. Caudal epidural block

    A caudal block does not selectively target the sympathetic chain.

  • D. Stellate ganglion block

    The stellate ganglion serves the upper limb and head and neck.

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.

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Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is B, Lumbar sympathetic block. Lumbar sympathetic blockade causes vasodilation in the lower limb by interrupting sympathetic outflow, improving skin blood flow and relieving ischaemic and sympathetically maintained pain.

Why is "Coeliac plexus block" not the answer?

The coeliac plexus supplies upper abdominal viscera.

Why is "Caudal epidural block" not the answer?

A caudal block does not selectively target the sympathetic chain.

Why is "Stellate ganglion block" not the answer?

The stellate ganglion serves the upper limb and head and neck.

What concept does this question test?

It tests Pain: lumbar sympathetic block in Anaesthesia. It is also used in CRPS of the lower limb. The stellate ganglion block serves the upper limb and head.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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: lumbar sympathetic 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.