The Optimal Oblique and Axial Angle of Fluoroscope for Superior Hypogastric Plexus Block

The recommended entry angle for superior hypogastric plexus block is different among references, and there is a need for suggesting a more accurate entry angle for this procedure. The investigators are trying to evaluate the entry angle for superior hypogastric plexus block by measuring these angle on the computed tomography image and apply these angle to the real patients.

Study Overview

• Status: Completed
• Conditions: Chronic Pelvic Pain; Superior Hypogastric Plexus Block; Pelvic Malignancy

Detailed Description

Superior hypogastric plexus block is a kind of sympathetic plexus block which are used to control the pelvic pain caused by malignancy or other chronic condition. Classic posterior approach for this procedure is inserting the block needle at L4 -5 level and proceed the needle 45 degrees medially and 30 degrees caudally to reach the target of anterolateral space of L5 - S1 intervertebral space. Waldman et al. introduced a different angle of 30 degrees medial and caudal with the same approach, while Stevens et al. recommended 15 degrees medial and 20 degrees caudal. As such, the recommended angle for this procedure is different among references, and there is a need for suggesting a more accurate entry angle for this procedure. Therefore, we are trying to evaluate the entry angle for superior hypogastric plexus block by measuring these angle on the computed tomography image and apply these angle to the real patients.

• Study Type: Observational
• Enrollment (Actual): 268

Contacts and Locations

Study Locations

• Korea, Republic of
  • Seoul, Korea, Republic of, 135-710
    • Samsung Medical Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 20 years to 80 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Those undergoing abdominopelvic CT scan with pelvic malignancy or chronic pelvic pain with constitutional disease

Description

Inclusion Criteria:

• Those undergoing abdominopelvic CT scan with pelvic malignancy or chronic pelvic pain with constitutional disease

Exclusion Criteria:

• Poor CT image with non-measurable axial or oblique entry angle

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort
Pelvic malignancy group; those with diagnosis of gynecologic or urologic malignancy
Pelvic chronic disease group; those with chronic pelvic pain with constitutional cause e.g. endometriosis

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
the oblique entry angle	the oblique entry angle of superior hypogastric plexus block at L5-S1 level	1 month after abdominopelvic CT scan performed

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
the axial entry angle	the axial entry angle of superior hypogastric plexus block at L4-S1 level	1 month after abdominopelvic CT scan performed

Collaborators and Investigators

• Sponsor: Samsung Medical Center
• Investigators: Principal Investigator: Woo Seog Sim, MD, PhD, Samsung Medical Center; Principal Investigator: Hye Won Song, MD, Samsung Medical Center

Study record dates

Study Major Dates

• Study Start: April 1, 2012
• Primary Completion (Actual): December 1, 2012
• Study Completion (Actual): December 1, 2012

Study Registration Dates

• First Submitted: May 22, 2012
• First Submitted That Met QC Criteria: May 23, 2012
• First Posted (Estimate): May 24, 2012

Study Record Updates

• Last Update Posted (Estimate): December 25, 2013
• Last Update Submitted That Met QC Criteria: December 24, 2013
• Last Verified: December 1, 2013

More Information

Terms related to this study

• Keywords: superior hypogastric plexus block; chronic pelvic pain; pelvic malignancy
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Neoplasms; Pelvic Pain
• Other Study ID Numbers: 2012-03-074