Open AccessEfficacy of the Anterior Ultrasound‐Guided Superior Hypogastric Plexus Neurolysis in Pelvic Cancer Pain in Advanced Gynecological Cancer Patients
Author(s) -
Mishra Seema,
Bhatnagar Sushma,
Rana Shiv P. S.,
Khurana Deepa,
Thulkar Sanjay
Publication year - 2013
Publication title -
pain medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.893
H-Index - 97
eISSN - 1526-4637
pISSN - 1526-2375
DOI - 10.1111/pme.12106
Subject(s) - medicine , neurolysis , visual analogue scale , brief pain inventory , cancer pain , pelvic pain , malignancy , anesthesia , surgery , cancer , chronic pain , physical therapy
Background and Aims Pelvic cancer pain is a chronic pain related to the involvement of viscera, neural, and pelvic muscular. The study was carried out to evaluate the efficacy of anterior ultrasound‐guided superior hypogastric plexus neurolysis in pelvic cancer pain in gynecological cancer patients. Material & Methods The study was conducted after approval of our I nstitutional E thics C ommittee. A total of 50 patients diagnosed with the advanced stage of a gynecological malignancy with severe pelvic pain were enrolled and randomly divided in two groups; in G roup I , patients were given oral morphine, while in G roup II , patients underwent anterior ultrasonography ( USG )‐guided superior hypogastric neurolysis. Oral morphine was given as rescue analgesia in both the groups. The parameters recorded were pain, functional capacity, global satisfaction score, and adverse effects. Results There was a significant decrease in visual analog scale ( VAS ) score in the both groups, but the decline in VAS scores from baseline in G roup II was significantly ( P < 0.05) greater. The daily morphine consumption in G roup II decreased throughout the study, and more patients in G roup II improved in their functional capacity, although it was statistically insignificant. It was observed that global satisfaction scores were better in G roup II during the initial first ( P = 0.001) week and 1 month ( P = 0.04) compared with G roup I . Conclusion The anterior USG ‐guided superior hypogastric plexus neurolysis is a useful technique in relieving pelvic pain in gynecological malignancies. However, it requires expertise to perform the block. It also avoids the radiation exposure involved with computed tomography‐guided and fluoroscopy‐guided superior hypogastric block.