Comparison between fluoroscopic posterior versus ultrasound-guided anterior approach for superior hypogastric plexus neurolysis: a prospective, randomized, comparative study

Kamel, Mona M.; Ahmed, Ahmed Shaker R; Shaaban, Mohamed R.; Hashem, Rania H.

doi:10.4103/2356-9115.195882

Cited by 4 publications

(11 citation statements)

References 2 publications

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“…Another study by Kamel et al comparing fluoroscopic guided versus anterior ultrasound guided SHPB showed pain relief in both groups with no significant difference, also there was improvement in PGIC, patient satisfaction score (PSS), and opioid consumption from the pre-procedure values with no significant difference between the two groups. 12 …”

Section: Discussionmentioning

confidence: 99%

“…Based on a similar study done by Kamel et al 12 showing the efficacy of an ultrasound guided anterior approach for superior hypogastric plexus neurolysis based on the VAS score measured before the procedure and after 3 months in either group: significant level or probability of type 1 error=0.05, power of the test statistics to be 90%, expected within-group standard deviation of 1.5, a critical difference of 2.9 (drop in VAS score), and ratio of sample size Group 2 /sample size Group1 =1, a minimum of 6 patients per group with a total of 12 patients are enough to see that effect.…”

Section: Methodsmentioning

confidence: 96%

“…The selective technique of intervention is required only in 10-15% of the cancer patients with severe pain resistant to traditional opioid and co-analgesic therapies. 17 Similarly, in the studies by Mishra et al 7 and Kamel et al, 12 using ultrasound guided SHPB, they concluded that this technique has potential drawbacks. There is the potentiality of injury to structures overlying and surrounding the SHP such as the lumbo-sacral plexus, bladder, ureters, uterus, bowed and iliac vessels, and the risk of infection from perforating the bowel.…”

mentioning

confidence: 94%

“…10 Another study by Kamel et al comparing fluoroscopic guided versus anterior ultrasound guided SHPB showed pain relief in both groups with no significant difference, also there was improvement in PGIC, patient satisfaction score (PSS), and opioid consumption from the preprocedure values with no significant difference between the two groups. 12 Kawamata et al evaluated the effectiveness of celiac block on QOL and pain relief with traditional morphine and NSAID treatment. 11 It was concluded that celiac block does not directly improve QOL in pancreatic cancer but it…”

mentioning

confidence: 99%

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The Role of Double Modality Ultrasonographic and Fluoroscopic Guided Superior Hypogastric Plexus Neurolysis in Treating Intractable Pelvic Cancer Pain: A Comparative Study

Abdelghafar¹,

Othman²,

Soliman³

et al. 2021

JPR

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Background Superior hypogastric neurolytic block is performed to block visceral pelvic pain. This could be performed through the anterior approach guided by CT or ultrasound and through a posterior approach, guided by fluoroscopy or CT. Methods Sixty adult patients with severe visceral pelvic pain (VAS>70 mm) were randomly divided into two groups. Group S: SHP block was done ultrasound guided using the anterior approach and confirmed by fluoroscopy. Group F: SHP block was done fluoroscopic guided using the posterior oblique approach. The VAS (visual analog scale), duration of the technique, time of X-ray exposure, patient satisfaction score, patient global impression of change (PGIC), quality of life score, and daily morphine consumption (mg/day) were measured pre-procedure and at the 1st, 4th, 8th, and 12th week after the procedure. In addition, any side effects of the procedure were recorded. Results There was a significant difference in VAS between the two groups ( P <0.01) (better in group S). The quality of life score was improved from the pre-procedure in both groups ( P <0.05), and morphine consumption was significantly lower in group S than in group F ( P <0.05) at the 1st, 4th, and 8th week and not significant at the 12th week. The two groups show a statistically significant difference as regards the duration of the procedure and X-ray exposure ( P <0.01). There was a statistically significant difference in the satisfactory score between the two groups at the 1st, 4th, 8th, and 12th week ( P <0.01). As regards the PGIC score, there was no statistically significant difference between the two groups ( P >0.05). In group S, no back pain was reported, while 11 patients of group F complained from post-procedure back pain ( P <0.001). Conclusion The anterior ultrasound guided SHPB aided by fluoroscopy is suggested to be more superior to the standard fluoroscopic guided technique in relieving pelvic cancer pain and decreasing morphine consumption.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 96%

mentioning

confidence: 94%

mentioning

confidence: 99%

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The Role of Double Modality Ultrasonographic and Fluoroscopic Guided Superior Hypogastric Plexus Neurolysis in Treating Intractable Pelvic Cancer Pain: A Comparative Study

Abdelghafar¹,

Othman²,

Soliman³

et al. 2021

JPR

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“…A superior hypogastric plexus block is one of the procedures proposed for the management of patients with pelvic visceral pain (8). This procedure is usually performed in the prone position with a pillow under the abdomen to achieve a better view while advancing the needles toward the anterolateral surface of the junction of the L5 - S1 (9).…”

Section: Discussionmentioning

confidence: 99%

Superior Hypogastric Plexus Block in the Lateral Position: A Case Report

et al. 2019

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IntroductionPatients with severe visceral abdominal or pelvic pain are sometimes candidates for celiac or superior hypogastric block. These blocks are performed in the prone position that is usually very painful for these patients. We introduce another position for these blocks that can be better tolerated.Case PresentationWe performed the superior hypogastric plexus block in the lateral position in a patient who was suffering from severe abdominal and pelvic pain. The procedure was done under the guide of C-Arm fluoroscopy. After the procedure, the pain score reduced to 2 out of 10 on the 11-point Numeric Rating Scale and the patient was discharged without any complication.ConclusionsSuperior hypogastric plexus block in the lateral position was safe and effective for a patient with severe abdominal and pelvic pain.

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