1.Application of anatomy The lumbar sympathetic ganglion, located in the anterolateral part of the vertebral body of the spine, generally has four on each side, connected to the lumbar sympathetic trunk by intersegmental branches, connected to the thoracic sympathetic trunk; descending between the anterolateral part of the lumbar vertebral body and the lumbaris major muscle, connected to the pelvic sympathetic trunk through the posterior part of the common iliac vessels into the pelvis; the right side is located outside the inferior vena cava or partially covered by the inferior vena cava; the left side is located outside the abdominal aorta. The sympathetic trunk is closer to the median line than that of the thorax. The paravertebral nodes of lumbar 1~2 participate in the abdominal aortic plexus and end at the inferior mesenteric ganglion, where the transforming neurons send out postganglionic fibers that climb the inferior mesenteric artery and are distributed. The paravertebral nodes of lumbar 3~4 join the inferior epigastric plexus, and here the ganglion converts to the neurons, and the postganglionic fibers are distributed to the digestive tube below the left curvature of the colon and the pelvic organs, and there are fibers with blood vessels distributed to the lower extremities. 2.Operating technique Lumbar sympathetic ganglion block Operating technique should be performed under the guidance of image monitor. Body surface positioning: the patient is placed in the upward lateral position on the puncture side, and the upper edge of the corresponding puncture spine is determined, and the local anesthetic mound is opened next to the median line and infiltrated layer by layer. A 12-cm-long, 7-gauge puncture needle is used at a 60-degree angle to the skin, and the needle is advanced toward the midline of the spine. The tip of the needle may touch the transverse process of the lumbar 1 vertebral body by advancing about 3-4 cm, or the tip of the needle may touch the lateral edge of the vertebral body by advancing 6-7 cm. The position of the puncture needle is shown by the image monitor, and the direction and depth of the puncture needle advancement are again adjusted until it is confirmed that the needle tip touches the sympathetic ganglion of the anterolateral aspect of the vertebral body without looking for foreign sensation. Injection of contrast agent was seen to show a linear distribution of images next to the vertebral body, which did not move with the abdominal organs. The air resistance disappearance test for injection is positive, there is no blood and no cerebrospinal fluid in the retraction, and the patient can feel a feverish sensation in the abdominal cavity when 8~10ml of local anesthetic is injected. After the injection of the drug, the affected side is taken to the upward lateral position in order to make the drug dip to the location where the lumbar sympathetic ganglion is located. If the patient needs to apply this method for long-term treatment, after successful puncture, an extra-membranous catheter should be placed and continuous lumbar sympathetic block can be performed. 3. Indications For pain-based diseases including renal colic, sympathetic nerve pain (SMP) such as burning neuralgia, phantom limb pain, etc. For the treatment of vasospastic diseases such as Raynaud’s disease; thrombo-occlusive vasculitis (Buerger’s), diabetic peripheral neuralgia, ischemic necrosis, lower limb ulcers, post-frostbite pain, etc. It is also used to dilate blood vessels in the lower extremities, increase peripheral flow, promote peripheral venous return, and improve lower extremity edema. Injections of nerve-destroying drugs can treat malignant or cancerous sympathetic neuralgia. (4. Complications and their prevention and treatment Accidental puncture into the subarachnoid space and epidural cavity causes extensive blockage after drug injection and leads to respiratory and circulatory disorders. Repeated punctures may damage nerves and cause neuralgia; there is also a chance of damaging large blood vessels or puncturing lumbar intervertebral discs, so extra care should be taken during the operation. Although the injected drug is in place and effective, attention should also be paid to the possible drop in blood pressure during treatment.