Dina Nabil1, Ali A Eissa. 1. Anesthesiology and Algology Department, National Cancer Institute, Cairo University, Egypt.
Abstract
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.
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.
Authors: Ivan Urits; Ruben Schwartz; Harish Bangalore Siddaiah; Sathyadev Kikkeri; David Chernobylsky; Karina Charipova; Jai Won Jung; Farnad Imani; Mohsen Khorramian; Giustino Varrassi; Elyse M Cornett; Alan David Kaye; Omar Viswanath Journal: Anesth Pain Med Date: 2021-02-16