Funding: This study was funded by All Instititue of Medical Sciences Research Grant.
Original Research Article
Efficacy of the Anterior Ultrasound-Guided Superior Hypogastric Plexus Neurolysis in Pelvic Cancer Pain in Advanced Gynecological Cancer Patients
Version of Record online: 11 APR 2013
Wiley Periodicals, Inc
Volume 14, Issue 6, pages 837–842, June 2013
How to Cite
Mishra, S., Bhatnagar, S., Rana, S. P. S., Khurana, D. and Thulkar, S. (2013), Efficacy of the Anterior Ultrasound-Guided Superior Hypogastric Plexus Neurolysis in Pelvic Cancer Pain in Advanced Gynecological Cancer Patients. Pain Medicine, 14: 837–842. doi: 10.1111/pme.12106
Conflict of Interest: The authors have no conflict of interest to report.
- Issue online: 20 JUN 2013
- Version of Record online: 11 APR 2013
- All Instititue of Medical Sciences Research Grant
- Pelvic Pain;
- Hypogastric Neurolysis;
- USG Superior Hypogastric Block;
- Gynecological Malignancies
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 Institutional Ethics Committee. 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 Group I, patients were given oral morphine, while in Group 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.
There was a significant decrease in visual analog scale (VAS) score in the both groups, but the decline in VAS scores from baseline in Group II was significantly (P < 0.05) greater. The daily morphine consumption in Group II decreased throughout the study, and more patients in Group II improved in their functional capacity, although it was statistically insignificant. It was observed that global satisfaction scores were better in Group II during the initial first (P = 0.001) week and 1 month (P = 0.04) compared with Group I.
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.