Anesthesiology and Algology Department, National Cancer Institute, Cairo University, Egypt.
Clin J Pain. 2010 Oct;26(8):694-7. doi: 10.1097/AJP.0b013e3181dedfa9.
The iliac crest and L5 transverse process are potential barriers to proper needle placement in superior hypogastric plexus block (SHPB) for pelvic cancer pain. Several investigators report successful SHPB using a paramedian transdiscal approach. Another new single puncture approach, posteromedian transdiscal, has been described which can be performed with the patient in either lateral or prone position.
Twenty-two patients were included in the study. Visual analog score, daily morphine consumption, duration of the procedure, side effects, and Quality of Life Questionnaire-C30 were recorded.
The duration of the procedure was 21.4 ± 6.5 minutes. The mean visual analog score, daily morphine consumption, and Quality of Life Questionnaire-C30 score were significantly decreased. There was no neural injury, headache, discitis, or disc herniation.
The posteromedian transdiscal approach to SHPB for cancer pain proved to be safe and reliable compared with the classic technique. No nerve or disc-related complications were noted.
髂嵴和 L5 横突是在骨盆癌痛的高位下腹下丛阻滞（SHPB）中进行适当的针置的潜在障碍。一些研究人员报告称，使用旁正中经椎间盘入路成功地进行了 SHPB。另一种新的单次穿刺方法，后正中经椎间盘入路，可以在患者侧卧位或俯卧位时进行。
本研究纳入了 22 名患者。记录视觉模拟评分、每日吗啡消耗量、手术持续时间、副作用和生活质量问卷-C30。
手术持续时间为 21.4 ± 6.5 分钟。平均视觉模拟评分、每日吗啡消耗量和生活质量问卷-C30 评分均显著降低。无神经损伤、头痛、椎间盘炎或椎间盘突出。
与经典技术相比，经后正中入路行 SHPB 治疗癌症疼痛安全可靠。未出现与神经或椎间盘相关的并发症。
