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Comparative study between computed tomography guided superior hypogastric plexus block and the classic posterior
Ayman A Ghoneim1, Sahar M Mansour2
1Department of Anesthesia and Pain Relief, National Cancer Institute, Cairo, Egypt.
Saudi Journal of Anaesthesia
|September 6, 2014
Summary
The CT-guided anterior approach for superior hypogastric plexus block (SHPB) offers a faster, safer, and more effective alternative to the classic posterior method. Patients reported higher satisfaction with the CT-guided technique, demonstrating its improved efficacy in pain management.
Area of Science:
- Pain Management
- Interventional Radiology
- Anesthesiology
Background:
- The classic posterior approach for superior hypogastric plexus block (SHPB) can be anatomically challenging due to bony obstructions.
- Computed tomography (CT)-guided anterior techniques offer a potential solution to these limitations.
Purpose of the Study:
- To prospectively compare the efficacy and safety of CT-guided anterior versus classic posterior approaches for SHPB.
- To evaluate patient outcomes including pain scores, analgesic consumption, and satisfaction.
Main Methods:
- A randomized controlled study involving 30 patients with chronic pelvic cancer pain.
- Patients were assigned to either the classic posterior or CT-guided anterior SHPB group.
- Outcomes assessed included Visual Analog Scale (VAS) pain scores, morphine consumption, patient satisfaction, procedure duration, and adverse effects.
Main Results:
- Both approaches significantly reduced VAS pain scores and morphine consumption post-procedure.
- The CT-guided anterior approach demonstrated a significantly shorter procedure duration.
- Patient satisfaction was significantly higher in the CT-guided anterior group compared to the classic posterior group.
Conclusions:
- CT-guided anterior SHPB is a superior technique, offering advantages in speed, safety, and effectiveness.
- This approach leads to enhanced patient satisfaction and potentially fewer side-effects compared to the classic posterior method.
