O Bloqueio do plexo hipogástrico superior é eficaz no tratamento de dor pélvica crônica?

Schmidt, André; Schmidt, Sérgio Renato Guimarães; Ribeiro, Sady M

doi:10.1590/s0034-70942005000600011

Cited by 19 publications

(9 citation statements)

References 17 publications

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“…In this context, the superior hypogastric plexus is considered an ideal target for nerve blocking to reduce pelvic visceral pain, [6] and it has been blocked to relieve both benign and malignant pain affecting the pelvic visceral structures. [6–10] …”

Section: Discussionmentioning

confidence: 99%

Pulsed radiofrequency treatment of the superior hypogastric plexus in an interstitial cystitis patient with chronic pain and symptoms refractory to oral and intravesical medications and bladder hydrodistension

Kim

2016

Medicine

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Rationale:A variety of therapeutic modalities are available for the treatment of interstitial cystitis. However, among them, the less invasive therapies are usually ineffective, whereas the invasive ones carry potential risks of serious side effects and complications. Pulsed radiofrequency (PRF) treatment of the superior hypogastric plexus may be an alternative to conventional treatments, as it provides nondestructive neuromodulation to the superior hypogastric plexus, which transmits the majority of pain signals from the pelvic viscera.Patient concerns:For 7 years, a 35-year-old female patient had been experiencing lower abdominal pain provoked by urinary bladder filling, perivulvar pain developing spontaneously during sleep or upon postural change, urinary urgency and frequency with 15- to 60-min intervals between urinations, and nocturia with 10 voids per night. Hydrodistension of the bladder, monthly intravesical administration of sterile sodium chondroitin sulfate, and oral medications including gabapentin and pentosan polysulfate had not been effective in managing the pain and symptoms.Diagnoses and interventions:Given the satisfactory result of a diagnostic block of the superior hypogastric plexus, 2 sessions of PRF treatment of the superior hypogastric plexus, which applied radiofrequency pulses with a pulse frequency of 2 Hz and a pulse width of 20 ms for 120 s twice per session to maintain the tissue temperature near the electrode at 42°C, were performed at a 6-month interval.Outcomes:This treatment relieved the pain and symptoms for 2 years and 6 months.Lessons:PRF treatment of the superior hypogastric plexus results in long-term improvements in the pain and symptoms associated with interstitial cystitis.

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Section: Discussionmentioning

confidence: 99%

Pulsed radiofrequency treatment of the superior hypogastric plexus in an interstitial cystitis patient with chronic pain and symptoms refractory to oral and intravesical medications and bladder hydrodistension

Kim

2016

Medicine

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“…The afferent fibers innervating the pelvic viscera (the bladder, uterus, vagina, prostate, testes, urethra, descending colon, and rectum) travel with sympathetic nerves, ganglia, superior hypogastric plexus (SHP), and therefore are amenable to percutaneous NSHB. [ 7 64 65 ] The SHP is a retroperitoneal structure located bilaterally from L3 to upper third of S1, close to sacral promontory and common iliac veins bifurcation. [ 7 64 ] Schmidt et al , reviewed the available literature and found NSHB to be safe and effective.…”

Section: Interventional Pain Management Guidelines According To Clinimentioning

confidence: 99%

“…[ 7 64 65 ] The SHP is a retroperitoneal structure located bilaterally from L3 to upper third of S1, close to sacral promontory and common iliac veins bifurcation. [ 7 64 ] Schmidt et al , reviewed the available literature and found NSHB to be safe and effective. [ 64 ] Mishra et al , in a recently conducted RCT reported NSHB to be superior to oral morphine with respect to pain score reduction, improvement in functional capacity, and global satisfaction score.…”

Section: Interventional Pain Management Guidelines According To Clinimentioning

confidence: 99%

“…[ 7 64 ] Schmidt et al , reviewed the available literature and found NSHB to be safe and effective. [ 64 ] Mishra et al , in a recently conducted RCT reported NSHB to be superior to oral morphine with respect to pain score reduction, improvement in functional capacity, and global satisfaction score. [ 66 ]…”

Section: Interventional Pain Management Guidelines According To Clinimentioning

confidence: 99%

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Evidence-based clinical practice guidelines for interventional pain management in cancer pain

Bhatnagar¹,

Gupta²

2015

Indian J Palliat Care

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Intractable cancer pain not amenable to standard oral or parenteral analgesics is a horrifying truth in 10–15% of patients. Interventional pain management techniques are an indispensable arsenal in pain physician's armamentarium for severe, intractable pain and can be broadly classified into neuroablative and neuromodulation techniques. An array of neurolytic techniques (chemical, thermal, or surgical) can be employed for ablation of individual nerve fibers, plexuses, or intrathecalneurolysis in patients with resistant pain and short life-expectancy. Neuraxial administration of drugs and spinal cord stimulation to modulate or alter the pain perception constitutes the most frequently employed neuromodulation techniques. Lately, there is a rising call for early introduction of interventional techniques in carefully selected patients simultaneously or even before starting strong opioids. After decades of empirical use, it is the need of the hour to head towards professionalism and standardization in order to secure credibility of specialization and those practicing it. Even though the interventional management has found a definite place in cancer pain, there is a dearth of evidence-based practice guidelines for interventional therapies in cancer pain. This may be because of paucity of good quality randomized controlled trials (RCTs) evaluating their safety and efficacy in cancer pain. Laying standardized guidelines based on existing and emerging evidence will act as a foundation step towards strengthening, credentialing, and dissemination of the specialty of interventional cancer pain management. This will also ensure an improved decision-making and quality of life (QoL) of the suffering patients.

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“…No que tange ao bloqueio anestésico dos nervos do plexo lombossacral, os trabalhos utilizam o homem como fonte de estudo (Schmidt et al 2005, Zugliani et al 2007, Imbelloni 2008.…”

Section: Introductionunclassified

Distribuição do nervo fibular comum em fetos de equinos e descrição anatômica de pontos para bloqueio anestésico

et al. 2012

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Pesq. Vet. Bras. 32 (7) The distribution of the nervus ϔibularis communis was analyzed in 30 equine fetuses, mongrel, from the collection of the Animal Anatomy Laboratory at the School of Veterinary Medicine of Universidade Federal de Uberlândia, which were injected and stored in an aqueous solution of 10% formaldehyde. It was found that this nerve emerges from the ischiadicus, divides itself into nervus ϔibularis profundus and nervus ϔibularis superϔicialis distributing to the musculi extensor digitorum lateralis, extensor digitorum longus, ϔibularis tertius, and tibialis cranialis. Drawing an imaginary line in the medial-lateral region of the tuberositatis tibia, the nervus ϔibularis communis may be blocked in its proximal portion, in the caudal third, between the tendon of insertion of the biceps femoris and the lateral side of the musculus gastrocnemius (medium third); and the nervus ϔibularis profundus may be blocked in the proximal tibia, cranio-distally to the nervus ϔibularis communis. The block of nervus ϔibularis profundus may be performed in two regions of the tibia: proximal, considering the imaginary line, distal to the site referred to the nervus ϔibularis communis, and caudal to that described for the nervus ϔibularis profundus; and distal, on the lateral side of the tibiotarsal joint, between the tendons of insertion of the musculi extensor digitorum lateralis and extensor digitorum longus.

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O Bloqueio do plexo hipogástrico superior é eficaz no tratamento de dor pélvica crônica?

Abstract: RESUMO

Cited by 19 publications

References 17 publications

Pulsed radiofrequency treatment of the superior hypogastric plexus in an interstitial cystitis patient with chronic pain and symptoms refractory to oral and intravesical medications and bladder hydrodistension

Pulsed radiofrequency treatment of the superior hypogastric plexus in an interstitial cystitis patient with chronic pain and symptoms refractory to oral and intravesical medications and bladder hydrodistension

Evidence-based clinical practice guidelines for interventional pain management in cancer pain

Distribuição do nervo fibular comum em fetos de equinos e descrição anatômica de pontos para bloqueio anestésico

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