الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Interventional procedures can be applied for diagnosis and treatment of patients with a pelvic cancer pain. Superior hypogastric plexus block is one of these interventional strategies for control pelvic pain. Evidence from previous studies indicates that neurolytic hypogastric plexus blocks are safe and effective in selected cancer patients. Superior hypogastric plexus neurolysis using the anterior USG - guided approach requires expertise to be performed. This study evaluated the efficacy of early use of anterior approach USG -guided: SHGPN on pelvic cancer pain quality and its impact on opioid requirements. Present study compared between two groups of patients in each group consisted of 25 patients with severe pelvic pain and VAS more than 3. Enrollment in this study was at OCMU pain clinic. Patients who included in the study were either gender, age between 20-70 years, ASA I and II, with BMI <30 and patients receiving opioids (tramadol) with VAS more than 3. Excluded patients were either refused the intervention, had allergy to drugs of the study, ascites, coagulation disorders, opioid addiction, infection at the puncture site, unstable medical disorders and pregnancy. After approval of IRB, Mansoura University, we started our study. Patients were divided in two equal groups each one is 25 patients, group I :( n= 25 patients) Subjects were treated with fentanyl patch according to WHO analgesic ladder. group II: (n = 25 patients) Subjects were treated with anterior approach US- guided SHGPN by ethyl alcohol 80%. Data regarding visual analogue pain score, opioid rescue doses, global satisfaction and functional capacity were collected. Incidence of side effects and complications as vomiting, hypotension, urinary retention, constipation, motor weakness and back pain were assessed. Our results showed reducing VAS, diminished opioid requirements and increased functional capacity after SHGPN in group II. We found that early use of anterior US-guided approach for SHGPN in pelvic cancer pain has a remarkable impact on pain relief more than patients receiving opioids only with less adverse effects and complications