Presacral neurolytic block for relief of pain from pelvic cancer: description and use of a CT-guided lateral approach

Abstract

A CT guided lateral approach for neurolysis of the presacral plexus is described for treatment of pelvic pain due to advanced cancer. The technique was evaluated in two patients with unrelieved pelvic and perineal pain. Other neurolytic techniques used to treat pelvic pain due to advanced cancer are reviewed with a discussion of benefits and potential side effects of this technique.

Keywords

analgesia neoplasm pain pelvic perineal presacral

Get full access to this article

View all access options for this article.

References

Bonica JJ . The management of pain of malignant disease with nerve blocks. Anesthesiology 1954; 15: 134–145.

de Leon-Casasola OA . Critical evaluation of chemical neurolysis of the sympathetic axis for cancer pain. Cancer Control 2000; 7: 142–148.

Jaboulay M . Le traitement de la nevralgie pelvienne par la paralysie du sympathique sacre. Lyon Med 1899; 90: 102–102.

LeRiche R . Resultats de la sympathectomie faite sur les arteres hypogastriques et ovariennes en gynaecologic. Presse Med 1925; 93: 465–465.

Cotte G . La sympathectomie hypogastrique, a-t-elle sa place dans la theapeutique gynecologique? Presse Med 1925; 33: 98–98.

Freier A . Pelvic neurectomy in gynaecology. Obstet Gynecol 1965; 25: 48–55.

Plancarte R , Amescua C , Patt RB , Aldrete A . Superior hypogastric plexus block for pelvic cancer pain. Anesthesiology 1990; 75: 236–239.

Plancarte R , Amescua C , Patt RB . Presacral blockade of the ganglion impar. Anesthesiology 1990; 73: A751–A751.

Plancarte R , de Leon-Casasola O , El-Helaly M , Allende S , Lema M . Neurolytic superior hypogastric plexus block for chronic pelvic pain associated with cancer. Reg Anesth 1997; 22: 562–568.

10.

Ina H , Kobayashi M , Imai S , Fukada Y , Narita M , Otagiri T . A new approach to superior hypogastric plexus block: trans-intervertebral disc (L5-S1 disc) technique. Reg Anesth 1992; 17(suppl): 123–123.

11.

Waldman SD , Wilson W , Kreps RD . Superior hypogastric plexus block using a single needle and computed tomography guidance: description of a modified technique. Reg Anesth 1991; 16: 286–287.

12.

Wechsler R , Maurer P , Halpern E , Frank E . Superior hypogastric plexus block for chronic pelvic pain in the presence of endometriosis: CT techniques and results. Radiology 1995; 196: 103–106.

13.

Kanazi G , Perkins F , Thakur R , Dotson E . New technique for superior hypogastric plexus block. Reg Anesth Pain Med 1999; 24: 473–476.