Document Detail

Evaluation of posteromedial transdiscal superior hypogastric block after failure of the classic approach.
MedLine Citation:
PMID:  20664339     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The iliac crest and L5 transverse process are potential barriers to proper needle placement in superior hypogastric plexus block (SHPB) for pelvic cancer pain. Several investigators report successful SHPB using a paramedian transdiscal approach. Another new single puncture approach, posteromedian transdiscal, has been described which can be performed with the patient in either lateral or prone position.
METHODS: Twenty-two patients were included in the study. Visual analog score, daily morphine consumption, duration of the procedure, side effects, and Quality of Life Questionnaire-C30 were recorded.
RESULTS: The duration of the procedure was 21.4 ± 6.5 minutes. The mean visual analog score, daily morphine consumption, and Quality of Life Questionnaire-C30 score were significantly decreased. There was no neural injury, headache, discitis, or disc herniation.
CONCLUSIONS: The posteromedian transdiscal approach to SHPB for cancer pain proved to be safe and reliable compared with the classic technique. No nerve or disc-related complications were noted.
Dina Nabil; Ali A Eissa
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Clinical journal of pain     Volume:  26     ISSN:  1536-5409     ISO Abbreviation:  Clin J Pain     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-15     Completed Date:  2011-01-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8507389     Medline TA:  Clin J Pain     Country:  United States    
Other Details:
Languages:  eng     Pagination:  694-7     Citation Subset:  IM    
Anesthesiology and Algology Department, National Cancer Institute, Cairo University, Egypt.
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MeSH Terms
Analgesics, Opioid / therapeutic use
Hypogastric Plexus / surgery*
Middle Aged
Morphine / therapeutic use
Nerve Block / methods
Neurosurgical Procedures / methods*
Outcome Assessment (Health Care) / methods
Pain Measurement / methods
Pelvic Neoplasms / complications
Pelvic Pain / drug therapy,  etiology,  psychology,  surgery*
Quality of Life
Retrospective Studies
Statistics, Nonparametric
Reg. No./Substance:
0/Analgesics, Opioid; 57-27-2/Morphine

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