Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Int J Med Sci. 2021 Jun 11;18(13):2957-2963. doi: 10.7150/ijms.60962. eCollection 2021.
The ganglion impar (ganglion of Walther) block has been used to manage coccygeal and perineal (perianal and genital) pain due to both benign and malignant causes. However, the factors associated with successful responses to ganglion impar block are unknown. Therefore, in the present study, we aimed to identify the independent factors associated with successful responses to ganglion impar block in patients with chronic pain in coccygeal and perineal regions. From January 2008 to December 2017, we performed a retrospective review of 106 patients who underwent ganglion impar block. Patients were considered successful responders if they reported a decrease of more than 50% or 4 points on the 11-point (0 = no pain and 10 = worst possible pain) numerical rating scale 1 month after the procedure, while others were considered non-responders. Logistic regression analysis was performed to identify factors independently associated with successful responses at 1 month after the procedure. Multivariable logistic regression analysis showed that cancer-related causes were significantly associated with successful responses at 1 month after ganglion impar block (odds ratio = 2.60, 95% confidence interval = 1.05 to 6.43, = 0.038). Ganglion impar block may be more effective in cancer-related pain than pain due to benign causes.
孤神经节(Walther 神经节)阻滞已被用于治疗因良性和恶性原因引起的尾骨和会阴(肛周和生殖器)疼痛。然而,成功应对孤神经节阻滞的相关因素尚不清楚。因此,在本研究中,我们旨在确定与慢性尾骨和会阴区域疼痛患者孤神经节阻滞成功反应相关的独立因素。
从 2008 年 1 月至 2017 年 12 月,我们对 106 例行孤神经节阻滞的患者进行了回顾性研究。如果患者在手术后 1 个月报告疼痛评分下降超过 50%或 4 分(0 分为无痛,10 分为最痛),则认为其为成功应答者,否则为无应答者。采用逻辑回归分析来确定术后 1 个月时与成功应答相关的独立因素。
多变量逻辑回归分析显示,癌症相关病因与孤神经节阻滞术后 1 个月的成功应答显著相关(比值比=2.60,95%置信区间=1.05 至 6.43,P=0.038)。
孤神经节阻滞在治疗癌症相关疼痛方面可能比治疗良性病因引起的疼痛更有效。