Department of Anesthesiology and Pain Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.
Korean J Pain. 2012 Jan;25(1):38-42. doi: 10.3344/kjp.2012.25.1.38. Epub 2012 Jan 2.
Chronic pelvic pain is a common problem with variable etiology. The sympathetic nervous system plays an important role in the transmission of visceral pain regardless of its etiology. Sympathetic nerve block is effective and safe for treatment of pelvic visceral pain. One of them, the inferior hypogastric plexus, is not easily assessable to blockade by local anesthetics and neurolytic agents. Inferior hypogastric plexus block is not commonly used in chronic pelvic pain patients due to pre-sacral location. Therefore, inferior hypogastric plexus is not readily blocked using paravertebral or transdiscal approaches. There is only one report of inferior hypogastric plexus block via transsacral approach. This approach has several disadvantages. In this case a favorable outcome was obtained by using coccygeal transverse approach of inferior hypogastric plexus. Thus, we report a patient who was successfully given inferior hypogastric plexus block via coccygeal transverse approach to treat chronic pelvic pain conditions involving the lower pelvic viscera.
慢性盆腔痛是一种常见的病症,其病因多种多样。无论病因如何,交感神经系统在内脏疼痛的传递中都起着重要作用。交感神经阻滞治疗盆腔内脏痛有效且安全。其中,下腹下丛由于其位于骶前位置,用局部麻醉药和神经溶解剂不易阻滞。由于这个原因,下腹下丛阻滞在慢性盆腔痛患者中并不常用。因此,经椎间孔或经皮途径不易阻滞下腹下丛。仅有一例经骶骨途径行下腹下丛阻滞的报道。该方法有几个缺点。在这种情况下,通过尾骨横突入路行下腹下丛阻滞获得了良好的效果。因此,我们报告了一例成功通过尾骨横突入路行下腹下丛阻滞治疗涉及下盆腔内脏的慢性盆腔疼痛的患者。