Computed Tomography Scan-guided Neurolytic Superior Hypogastric Block Complicated by Somatic Nerve Damage in a Severely Kyphoscoliotic Patient

Chan, WC; Peh, Wilfred C.G.; Ng, Kkc; Tsui, S. L.; Yang, Joo Chul

doi:10.1097/00000542-199706000-00032

Cited by 7 publications

(7 citation statements)

References 2 publications

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“…Serious injury to the somatic nerve in a patient with severe kyphoscoliosis has been described. 9 Injury to or irritation (chemical neuritis) of the lumbar plexus and the genitofemoral nerve can likewise not be excluded. 10 Alteration of regional anatomy (kyphoscoliosis) may even result in ureteral injury.…”

Section: Discussionmentioning

confidence: 99%

“…10 Alteration of regional anatomy (kyphoscoliosis) may even result in ureteral injury. 9,10 Although the transdiscal technique carries a minimal risk of injury to the nerve roots or vascular and ureteral injury, it may be associated with aseptic discitis and/or mechanical damage to the disc. In a series of 20 patients, Erdine et al did not report any complications in their study to assess a program of infectious complication prevention using intravenous antibiotic administration.…”

Section: Discussionmentioning

confidence: 99%

“…5 Fluoroscopy-guided anterior approaches may result in injury mainly to the iliac vessels (artery and vein), as vascular structures can only be visualized by fluoroscopy in cases of advanced atherosclerosis. 9 The CT-guided anterior approach was originally described by Cariati et al for cancer-related pelvic pain. 18 A decrease in pain intensity was noted in 8 out of 10 patients.…”

Section: Discussionmentioning

confidence: 99%

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Computed Tomography-Guided Anterior Approach to the Superior Hypogastric Plexus for Noncancer Pelvic Pain: A Report of Two Cases

Michálek¹,

Dutka²

2005

The Clinical Journal of Pain

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The objective of this study was to evaluate the possibility and describe the methodology of a computed tomography-guided anterior approach to superior hypogastric plexus block for noncancer pain. A computed tomography-guided anterior approach to the superior hypogastric plexus was used in 2 patients with pelvic pain and anatomic disturbance of the lumbar spine, which was a contraindication to the conventional dorsal approach. The first case was a 43-year-old patient suffering from burning pain of the urethra. Pain relief using analgesics and antidepressants was insufficient. The posterior approach was excluded due to coexisting irritation of the L5 nerve root. The second case was a 68-year-old man suffering from chronic burning and itching pain of the urethra and glans penis. Conservative therapy (anti-inflammatory drugs, tramadol, spasmolytics) failed to provide satisfactory pain relief. The posterior approach was contraindicated because of laterally prominent L5 vertebral body osteophytes. Both patients received a prognostic block to the superior hypogastric plexus via the anterior approach guided by computed tomography. Visual analog scale scores prior to the block were 6 to 7 and 5 to 6, respectively. The visual analog scale scores 24 hours after the block were 1 and 0, respectively. The second patient received a permanent neurolytic block via the anterior approach to provide long-term pain relief. In conclusion, the authors describe the computed tomography-guided anterior approach to the superior hypogastric plexus for chronic pelvic pain. The technique is simple to perform, and the analgesic effect is satisfactory. More extensive studies are necessary to evaluate the safety of this approach.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Computed Tomography-Guided Anterior Approach to the Superior Hypogastric Plexus for Noncancer Pelvic Pain: A Report of Two Cases

Michálek¹,

Dutka²

2005

The Clinical Journal of Pain

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“…Os quatro relatos de caso encontrados nesta revisão não apresentaram poder adequado para embasar a utilização do bloqueio do plexo hipogástrico superior. Em uma correspondência, Chan e col. 27 descreveram um caso de bloqueio guiado por tomografia computadorizada para tratamento de dor perineal crônica oncológica em um paciente com cifoescoliose grave. Após duas semanas do procedimento, o paciente fazia uso de morfina oral 60 mg.dia -1 com bom alívio da dor.…”

Section: Desenvolvimentounclassified

“…The four case reports found in this review had no adequate power to support the use of superior hypogastric plexus block. In a letter, Chan et al 27 have described a case of blockade guided by CT-scan to treat chronic oncologic perineal pain in a patient with severe kyphoscoliosis. Two weeks after the procedure, patient was under 60 mg.day -1 oral morphine with satisfactory pain relief.…”

Section: Developmentmentioning

confidence: 99%