CT-Guided Superior Hypogastric Plexus Block

Abstract

PURPOSE: This study reports our experience with CT-guided block in the superior hypogastric plexus, using a single needle and anterior approach, in patients with pelvic cancer. METHOD: Ten patients with pelvic malignancy underwent CT-guided hypogastric neurolytic block with alcohol via an anterior approach. A solution of 10, 15, or 20 ml of alcohol, 4 ml of bupivacaine HCl, and 2 ml of contrast medium was injected. The results were evaluated based on pain relief, using a four-grade analogue scale. RESULTS: CT images always showed spread of solution around the iliac vessels. Pain relief was complete in four cases, moderate in two, mild in three, and none in one. Best results were observed with the largest amounts of alcohol. CONCLUSION: CT-guided percutaneous superior hypogastric block is a safe, relatively easy, and effective procedure in patients with severe pain from pelvic malignancies.