J Korean Pain Soc.  2000 Nov;13(2):202-207.

Trans-intervertebral Disc Approach of Superior Hypogastric Plexus Block for Pelvic Cancer Pain A Retrospective Study

• Lee YW
• Yoon DM
• Lee GM
• Han ST
• Park HJ

Abstract

BACKGROUND: Superior hypogastric plexus block has been advocated as a useful technique for the treatment of cancer related pelvic pain. The aim of this study was to evaluate the effect of neurolytic trans-intervertebrodiscal superior hypogastric plexus block for pelvic cancer pain.
METHODS
Twenty-eight patients with gynecologic, colorectal or genitourinary cancer who suffered intractable pain were studied. We performed superior hypogastric plexus block by trans-intervertebrodiscal approach at L5/S1 level under the C-arm fluoroscopic guide unilaterally or bilaterally. Ten ml of 100% dehydrated alcohol was injected through each needle. We evaluated the change of visual analog pain score (VAS; 0-100 mm) and daily dose of oral morphine sulphate at the time of pre-block and 7 days after the block.
RESULTS
Fourteen patients (50%) had satisfactory pain relief (VAS<30) while five patients (18%) had moderate pain control (VAS 30-60). The remaining nine patients (32%) had mild or little pain relief (VAS>60) and their daily oral morphine doses were above 160 mg. Additional pain control method may be needed for those patients who received high dose of opioid before neurolytic block.
CONCLUSIONS
We conclude trans-intervertebrodiscal neurolytic superior hypogastric plexus block was effective in relieving pelvic cancer pain. Neurolytic block, earlier stage, may provide better effects for more comfortable life at the end stage for cancer patients.

Keyword

Pain pelvic; cancer; Technique superior hypogastric plexus block; Trans-intervertebrodiscal approach

MeSH Terms

Humans
Hypogastric Plexus*
Morphine
Needles
Pain, Intractable
Pelvic Neoplasms*
Pelvic Pain
Retrospective Studies*
Urogenital Neoplasms
Morphine