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

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.

Inclusion Criteria:

• Unbearable cancer pain that is resistant to WHO (World Health Organization) pain ladder at least 2 weeks medication
• The patient is tired of taking medication orally or complications of current medication (respiratory depression, nausea, vomiting, opioid-induced constipation, gastrointestinal disturbances)
• Patients with pelvic floor pain diagnosed by a (Fellow of Interventional Pain Practice) FIPP-certified pain specialist
• Patients with pain in the perineum diagnosed by a FIPP-certified pain specialist
• Numerical Rating Scale >4
• >18 years old
• Able and willing to sign an informed consent

Exclusion Criteria:

• Refuse to be included in the research
• Blood clotting disorders (including taking anticoagulant drugs)
• Local infection in the area of action
• Loss to follow up

Drop-out Criteria:

• Loss to follow up
• Intervention complications occur
• Failed intervention