Neoplasms

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Pelvic Neoplasms

Central Nervous System Depressants

All Drugs and Chemicals

Bupivacaine

ultrasound guided superior hypogastric plexus block using 20 ml Bupivacaine 0.5% before skin incision.

ultrasound guided superior hypogastric plexus block using 20 ml normal saline 0.9% instead of bupivacaine.

Pre operative ultrasound guided superior hypogastric plexus block in pelvic surgeries using a curvilinear probe below umbalicus with needle in plane technique to reach the plexus in front of L5 vertebra

Superior Hypogastric Plexus Block

Mohamed abdel wadod, MD

The superior hypogastric plexus (SHP) is a retroperitoneal structure with a predominance of afferent sympathetic nerve fibers. The perception of central pelvic pain is thought mainly to involve transmission through this plexus. Therefore, blocking or of SHP has been used to treat pelvic pain.

Ultrasound guided superior hypogastric plexus block there is 2 equal groups:

Group S (SHPB group 18 patients) ultrasound guided SHPB is done after induction of balanced general anesthesia (fentanyl, propofol and rocuronium) using 20 ml Bupivacaine 0.5% before skin incision, Group C (Control group 18 patients) in which same technique will be done but using normal saline 0.9% instead of bupivacaine. Patients of both groups will receive patient controlled analgesia using morphine with continous background infusion of morphine 1.5 mg/h with adding granisterone 2mg/60 ml and ability to give bolus of 0.5 mg morphine on demand.

• Dosing and administration; Group S (SHPB group 18 ultrasound guided SHPB ) using 20 ml Bupivacaine 0.5% before skin incision.

Group C (Control group 18 patients) in which same technique will be done but using normal saline 0.9%

Group S (SHPB group 18 ultrasound guided SHPB ) using 20 ml Bupivacaine 0.5% before skin incision.

Group C (Control group 18 patients) in which same technique will be done but using normal saline 0.9%

Randomization is done using computer generated sequence. Concealment will be achieved by opaque envelope.

Pre-emptive US Guided Superior Hypogastric Plexus Block in Pelvic Cancer Surgeries : a Randomized Double-Blinded Study

Pre-emptive Ultrasound Guided Superior Hypogastric Plexus Block in Pelvic Cancer Surgeries : a Randomized Double-Blinded Study

Total 24 hours morphine consumption in milligrams

scale in which 0 is least pain and 10 is sever pain

National Cancer Institute, Egypt

Mohammed Abdelfattah Abdelwadod

Symptoms and General Pathology

Nervous System Diseases

Rare Diseases

Pain

Pelvic Pain

Neurologic Manifestations

Chronic Graft Versus Host Disease

those with diagnosis of gynecologic or urologic malignancy

those with chronic pelvic pain with constitutional cause e.g. endometriosis

Woo Seog Sim, MD, PhD

Won Ho Kim, MD

Hye Won Song, MD

The recommended entry angle for superior hypogastric plexus block is different among references, and there is a need for suggesting a more accurate entry angle for this procedure. The investigators are trying to evaluate the entry angle for superior hypogastric plexus block by measuring these angle on the computed tomography image and apply these angle to the real patients.

Superior hypogastric plexus block is a kind of sympathetic plexus block which are used to control the pelvic pain caused by malignancy or other chronic condition. Classic posterior approach for this procedure is inserting the block needle at L4 -5 level and proceed the needle 45 degrees medially and 30 degrees caudally to reach the target of anterolateral space of L5 - S1 intervertebral space. Waldman et al. introduced a different angle of 30 degrees medial and caudal with the same approach, while Stevens et al. recommended 15 degrees medial and 20 degrees caudal. As such, the recommended angle for this procedure is different among references, and there is a need for suggesting a more accurate entry angle for this procedure. Therefore, we are trying to evaluate the entry angle for superior hypogastric plexus block by measuring these angle on the computed tomography image and apply these angle to the real patients.

The Optimal Oblique and Axial Angle of Fluoroscope for Superior Hypogastric Plexus Block

the oblique entry angle of superior hypogastric plexus block at L5-S1 level

the axial entry angle of superior hypogastric plexus block at L4-S1 level

Samsung Medical Center

Professor

Cancer Pain

Chronic Pain

Analgesics

pulsed radiofrequency at S3 nerve root + superior hypogastric plexus block

superior hypogastric plexus chemical neurolysis

superior hypogastric plexus block

pulsed radiofrequency neuromodulation at S3 root plus superior hypogastric plexus chemical neurolysis

pulsed radiofrequency at S3 root plus superior hypogastric plexus block

The investigators hypothesis that adding pulsed radiofrequency neuromodulation at S3 nerve root to superior hypogastric plexus chemical neurolysis improves analgesia in patients with chronic pelvic cancer pain.

S3 Root Pulsed Radiofrequency Added to Superior Hypogstric Plexus Block

the Added Analgesic Effect of S3 Root Pulsed Radiofrequency to Superior Hypogastric Plexus Block in Pelvic Cancer Pain. a Controlled, Randomized Study

including transient paresthesia, rectal puncture, vascular penetration of one of the pelvic vessels, hematoma, infection, dural puncture, bowel/bladder dysfunction, pain on injection, hypotension from the sympathetic block or any other complication

Assiut University

Assisstant Professor of Anesthesia, ICU, and Pain management

Urinary Tract, Sexual Organs, and Pregnancy Conditions

Skin and Connective Tissue Diseases

Uterine Cervical Neoplasms

Ganglion Cysts

Synovial Cyst

Endometrial Neoplasms

Cysts

Uterine Neoplasms

Genital Neoplasms, Female

Urogenital Neoplasms

Uterine Cervical Diseases

Uterine Diseases

Genital Diseases, Female

Genital Diseases

Urogenital Diseases

Female Urogenital Diseases

Pregnancy Complications

Female Urogenital Diseases and Pregnancy Complications

Mucinoses

Connective Tissue Diseases

Anti-Arrhythmia Agents

Channel Blockers

Anti-Infective Agents

Lidocaine

Ethanol

Device: C-arm fluoroscopic device Drug: lidocaine + alcohol

this procedure uses a transdiscal approach at the level of the L5-S1 vertebrae by injecting 5 ml of 1% lidocaine + 10 ml of 96% alcohol and confirmed by C-arm.

this procedure uses a trans-sacrococcygeal approach by injecting 4 ml of 1% lidocaine + 6 ml of 96% alcohol and confirmed by C-arm.

Ganglion Impar Block

Ristiawan Muji Laksono, MD,FIPP

This study compared the efficacy and safety of superior hypogastric plexus block and ganglion impar block procedures on the management of pelvic and perineal cancer pain in patients with cervical and endometrial cancer

Superior hypogastric plexus block is a commonly used method for the management of pelvic and perineal pain due to cancer, this procedure uses a transdiscal approach at the level of the L5-S1 vertebrae by injecting 5 ml of 1% lidocaine + 10 ml of 96% alcohol and confirmed by C-arm.

Compared with the ganglion impar block procedure using a trans-sacrococcygeal approach by injecting 4 ml of 1% lidocaine + 6 ml of 96% alcohol and confirmed by C-arm. The aim of this study was to compare the efficacy and safety of the ganglion impar block procedure against the superior hypogastric plexus block which is commonly used in the management of pelvic and perineal pain due to cervical and endometrial cancer.

Patients were assigned to two groups.

Group 1: Patients with pelvic floor pain due to cervical and endometrial cancer who were treated with superior hypogastric plexus block.

Group 2: Patients with pelvic floor pain due to cervical and endometrial cancer who were given ganglion impar block.

Participant and Investigator masking:

The random order of the groups will be written on paper and hidden by using a sealed envelope with consecutive numbers. This envelope will be retained by personnel who are not involved in the care or evaluation of the patient, or the analysis of the data.

During the action, doctors and nurses are prohibited from communicating with participants regarding the actions given.

Outcomes assessor masking:

All data collection will be carried out by residents as research assistants who are trained for data collection. The assistant was not told what intervention was given to the patient, data collection was done directly by asking the patient without looking at the patient's status. The data that has been collected will be entered and processed by personnel outside the research team to ensure blinding.

Hypogastric Plexus Block and Ganglion Impar Block for Cervical and Endometrial Cancer Pain Management

Hypogastric Plexus Block and Ganglion Impar Block for Cervical and Endometrial Cancer Pain Management: A Randomized Controlled Trial of Efficacy and Safety

Used to measure pain relief with a value of 0-10 (0 = no pain, 1-3 = mild pain, 4-6 = moderate pain, 7-9 = severe pain, 10 = most severe pain). The average pain intensity felt by the patient in the last 1 week

The Oswestry Disability Index is a measuring tool to evaluate the quality of life and the level of disability. In this study, we will use the Indonesian adaptation version. in a journal published by Phedy et al showed that the Indonesian version of the ODI retains the reliability, validity, and psychometric characteristics of the original ODI.

There are 10 main questions with 6 assessment options from the lowest point of 0 and the highest point of 5.

0-20%: mild disability 21-40%: moderate disability, affecting activities can still be overcome 41-60%: severe disability, pain is a major problem and interferes with activities 61-80%: patients experience disturbances in major aspects of life requiring intervention 81-100%: the patient is confined to bed because of complaints

This is the dose that the patient takes regularly to relieve pain.

It is an unwanted effect due to the intervention given to the patient.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Pre-emptive US Guided Superior Hypogastric Plexus Block in Pelvic Cancer Surgeries : a Randomized Double-Blinded Study	NCT04732234	Analgesia	Superior Hypoga...	18 Years - 70 Years	National Cancer Institute, Egypt
The Optimal Oblique and Axial Angle of Fluoroscope for Superior Hypogastric Plexus Block	NCT01604837	Chronic Pelvic ... Pelvic Malignan... Superior Hypoga...		20 Years - 80 Years	Samsung Medical Center
S3 Root Pulsed Radiofrequency Added to Superior Hypogstric Plexus Block	NCT04782206	Pain Cancer Pain, Chronic	superior hypoga... pulsed radiofre...	18 Years - 70 Years	Assiut University
Hypogastric Plexus Block and Ganglion Impar Block for Cervical and Endometrial Cancer Pain Management	NCT05427058	Cervical Cancer Endometrial Can...	Superior Hypoga... Ganglion Impar ...	18 Years -	University of Brawijaya
Hypogastric Plexus Block and Ganglion Impar Block for Cervical and Endometrial Cancer Pain Management	NCT05427058	Cervical Cancer Endometrial Can...	Superior Hypoga... Ganglion Impar ...	18 Years -	University of Brawijaya
S3 Root Pulsed Radiofrequency Added to Superior Hypogstric Plexus Block	NCT04782206	Pain Cancer Pain, Chronic	superior hypoga... pulsed radiofre...	18 Years - 70 Years	Assiut University
Pre-emptive US Guided Superior Hypogastric Plexus Block in Pelvic Cancer Surgeries : a Randomized Double-Blinded Study	NCT04732234	Analgesia	Superior Hypoga...	18 Years - 70 Years	National Cancer Institute, Egypt
The Optimal Oblique and Axial Angle of Fluoroscope for Superior Hypogastric Plexus Block	NCT01604837	Chronic Pelvic ... Pelvic Malignan... Superior Hypoga...		20 Years - 80 Years	Samsung Medical Center

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