Neurolytic superior hypogastric plexus block under CT-guidance [BILGISAYARLI TOMOGRAFI ESLIGINDE NOROLITIK SUPERIOR HIPOGASTRIK PLEKSUS BLOGU (BIR TEKNIK)]

In this study, the method, efficacy and results of superior hypogastric plexus blockade (SHPB) under guidance of computed tomography in the treatment of malignancy-caused pelvic pain is reported. SHPB was performed in 12 selected patients who has intractable pelvic pain due to malignancy. Bilateral neurolytic SHPB was performed in prone position under CT-guidance. The puncture sites are both 7-8 cm lateral from the midline at the level of L4 spinous processus. Visual analog scale (VAS) was used for pain measurement just before and after the block, at 24 hours, 1 week and 3 months post-block. All patients had complete pain relief according to VAS scale (<4) just after the block. Oral morphine consumption decreased significantly after the block when compared to pre-block values (p<0.05). As for the complications, vascular puncture was done in 1 patients and another patient had transient leg paralysis and neuralgia. Neurolytic SHPB under CT-guidance is a specific and useful technique for malignancy-caused pelvic pain when pharmacologic treatment is inadequate