Fluoroscopic Anterior Approach Versus Ultrasound Guided Superior Hypogastric Plexus Neurolysis in Cancer Pelvic Pain
试验速览
- 阶段
- 2 期
- 入组人数
- 96
- 试验地点
- 1
- 主要终点
- The symptom burden was evaluated using the Edmonton Symptom Assessment System (ESAS)
研究概览
简要总结
Cancer related pelvic pain can be debilitating and difficult to treat. Superior hypogastric plexus neurolysis (SHPN) is considered to be an option for adequately relieving pain, with fewer side effects and improving the quality of life
详细描述
The superior hypogastric plexus (SHP) is one of the paravertebral sympathetic ganglia, located in the lower border of the L5 vertebra and upper part of the sacrum in the retroperitoneal space. It is considered as a continuity of the celiac plexus and the lumbar sympathetic ganglia. It is related to the bifurcation of the aorta and the ureters. The SHP has a sympathetic connection (both efferent and afferent fibers) with splanchnic nerves and aortic plexus. It innervates the viscera of the pelvis, including the urinary bladder, ureters, sigmoid colon down to the anal canal, and upper vagina SHP blockade can be performed either by ultrasound (US), fluoroscopic, computed tomography (CT) and Magnetic resonance imaging (MRI) techniques and it is conducted through anterior (transabdominal) or posterior (lateral, paramedian, oblique, transdiscal, or transvaginal) approaches These different imaging modalities and approaches have been described for SHPN to make it easier, safer and more accurate and satisfied to the patients
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 70 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients more than 18 years old of both genders with cancer-related pelvic pain,
- •poor pain control or severe side effects with opioid therapy,
- •≥ 4 on a numeric rating scale (NRS) of pain that ranged from 0 (no pain) to 10 (extreme pain).,
- •American society of Anesthesiology Physical Status class I and II,
- •positive diagnostic block day before the procedure by injecting a local anesthetic (0.25% bupivacaine 10 ml)
- •Body mass index ˂ 30 were included in this study.
排除标准
- •patient refusal,
- •local or systemic sepsis,
- •coagulopathy,
- •unstable cardiovascular and respiratory diseases,
- •previous neurological deficits,
- •history of psychiatric disorders,
- •history of drug abuse,
- •distorted local anatomy,
- •those who were allergic to the used medications were excluded from the study.
结局指标
主要结局
The symptom burden was evaluated using the Edmonton Symptom Assessment System (ESAS)
时间窗: 3 months from block
It includes the assessment of 10 symptoms experienced by cancer patients with the following 0-10 numeric rating scales: pain, fatigue, drowsiness, nausea, lack of appetite, depression, anxiety, shortness of breath, feeling of well-being, and insomnia
次要结局
- daily analgesic requirements(3 months from injection)
- time of the procedures(intraoperative)
- patient satisfaction(0ne month after block)
研究者
Nevert Adel
assist. prof. of anesthesia and pain management
Mansoura University