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

Tavakoli, Farhad; Yousefshahi, Fardin; Dabir, Arman; Majedi, Hossein

doi:10.5812/aapm.94706

Cited by 3 publications

(3 citation statements)

References 8 publications

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“…However, the prone position for patients suffering from abdominal or pelvic cancer pain is very painful and annoying. Moreover, the airway is not secured if the patient is sedated and the immediate airway management is difficult in this position [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Fluoroscopic anterior approach versus ultrasound guided superior hypogastric plexus neurolysis in cancer pelvic pain: a randomized controlled study

Abdelghaffar

Farahat

2022

BMC Anesthesiol

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Background Cancer-related pelvic pain can be difficult and debilitating to treat. Superior hypogastric plexus neurolysis (SHPN) is a good choice for adequate pain relief with fewer side effects. The current study compared between fluoroscopic anterior approach and ultrasound guided SHPN in the management of cancer-related pelvic pain. Methods Patients were randomly allocated into two equal groups. The ultrasound group (US group) (n = 48) received SHPN by an ultrasound-guided anterior approach using 3 ml 5% bupivacaine plus 20 ml 10% phenol, while the fluoroscopy group (n = 48) received SHPN by a fluoroscopy-guided anterior approach using 3 ml 5% bupivacaine plus 20 ml 10% phenol. Results The time of the procedure was shorter in the fluoroscopic group (21.31 ± 4.79 min) than the US group (24.88 ± 6.02 min) (P = 0.002). Patient satisfaction was higher in the fluoroscopy group (5.38 ± 1.482) than the US group (2.98 ± 1.495) (P˂0.001). The need for analgesia using morphine was significantly limited in each group, at 1, 2 and 3 months intervals (P1˂0.001, P2 ˂0.001 and P3 ˂0.001). There were statistically significant differences between both groups regarding fatigue at baseline, drowsiness at 3 months, nausea and vomiting at 1, 2 and 3 months and anorexia at 3 months. Group comparison also revealed statistically significant differences regarding depression at one month, anxiety at 2 and 3 months and insomnia at baseline. Conclusion The fluoroscopic anterior approach SHPN was more superior than the US guided SHPN regarding the time of the procedure and patient satisfaction, while both technique were similar regarding the numeric rating scale and the complications during block. Trial registration Registered in the ClinicalTrials.gov (Identifier: NCT05299047) at 28/03/2022.

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Section: Discussionmentioning

confidence: 99%

Fluoroscopic anterior approach versus ultrasound guided superior hypogastric plexus neurolysis in cancer pelvic pain: a randomized controlled study

Abdelghaffar

Farahat

2022

BMC Anesthesiol

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“…The superior hypogastric plexus innervate the pelvic structures, including the bladder, urethra, perineum, prostate, penis, testis, descending colon, rectum, perineum, vulva, and internal genitalia except the ovary and fallopian tubes (21). The superior hypogastric plexus is retroperitoneal, located bilaterally at the lower third of the fifth lumbar vertebral body and upper third of the first sacral vertebral body proximity to the bifurcation of common iliac vessels.…”

Section: Chronic Pelvic Painmentioning

confidence: 99%

Inferior Hypogastric Block for the Treatment of Chronic Pelvic Pain

et al. 2021

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Context: Pelvic pain is described as pain originating from the visceral or somatic system localizing to the pelvis, the anterior abdominal wall at the level of or below the umbilicus, lumbosacral back in either men or women. Evidence Acquisition: Narrative review. Results: Chronic pelvic pain can be a complex disorder that may involve multiple systems such as urogynecological, gastrointestinal, neuromusculoskeletal, and psychosocial systems. The etiopathogenesis for chronic pain remains unknown for many patients. For achieving optimal patient management, a multimodal and individualized assessment of each patient is the best strategy. Conclusions: There are non-pharmacologic treatments as well as pharmacologic treatments. In addition to these treatment options, inferior hypogastric plexus block is a promising treatment modality.

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“…For these patients with refractory cancer pain or intolerable adverse events, some modalities (8,9) and advanced pain management techniques are required to control pain, such as nerve blocks (10,11) or intrathecal drug administration (5,12,13). Central neural blockade is an important modality for cancer pain management, but one should always be careful about its side effects (14)(15)(16). Although neuromodulation has a special role in the treatment of chronic refrac-Copyright © 2021, Author(s).…”

Section: Introductionmentioning

confidence: 99%

Programmable Pump for Intrathecal Morphine Delivery to Cisterna Magna: Clinical Implications in Novel Management of Refractory Pain Above Middle Thoracic Vertebrae Level Utilizing a Prospective Trial Protocol and Review

et al. 2021

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Background: The cisterna Intrathecal Drug Delivery system (IDDS) with morphine has proven to be effective in treating refractory cancer pain above the middle thoracic vertebrae level in some countries. However, it has not been fully investigated in others. We designed the current project to investigate the efficacy and safety of cisterna IDDS for pain relief in refractory pain above the middle thoracic vertebrae level in advanced cancer patients. Methods: This study protocol allows for eligible cancer patients to receive the cisterna IDDS operation. Pain intensity (Visual Analogue scale, VAS), quality of life (36-Item Short-Form Health Survey, SF-36), and depression (Self-Rating Depression scale, SDS) are assessed along with side effects in the postoperative follow-up visits. Recent literature suggests a potential role for cisterna IDDS morphine delivery for refractory pain states above the middle thoracic level. Conclusion: The results of this study may provide further evidence that cisterna IDDS of morphine can serve as an effective and safe pain relief strategy for refractory pain above the middle thoracic vertebrae level in advanced cancer patients.

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

Cited by 3 publications

References 8 publications

Fluoroscopic anterior approach versus ultrasound guided superior hypogastric plexus neurolysis in cancer pelvic pain: a randomized controlled study

Fluoroscopic anterior approach versus ultrasound guided superior hypogastric plexus neurolysis in cancer pelvic pain: a randomized controlled study

Inferior Hypogastric Block for the Treatment of Chronic Pelvic Pain

Programmable Pump for Intrathecal Morphine Delivery to Cisterna Magna: Clinical Implications in Novel Management of Refractory Pain Above Middle Thoracic Vertebrae Level Utilizing a Prospective Trial Protocol and Review

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