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The efficacy of the ganglion impar block in perineal and pelvic cancer pain

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Abstract

Background

Visceral pain conducted by sympathetic fibers with pelvic and perineal origin can be treated using ganglion impar (GIB) or Walters’ block in a simple and effective manner. This article aims to evaluate the effectiveness, security, and performance difficulty of GIB in patients with pelvic and perineal oncological pain.

Methods

A retrospective study between January 2016 and August 2017. Patients with poorly controlled pelvic oncological pain and patients experimenting opioid side effects in which GIB was performed ambulatory were included. Prognostic GIB was performed, under echographic and fluoroscopic control, with local anesthetic and corticoid. The neurolytic block was performed under fluoroscopic guidance. The technique was performed by the same anesthetist with pain management competence. For statistical analysis, Microsoft Excel 2013® and IBM SPSS Statistics version 22.0 were used.

Results

Fifteen patients were included. One patient was excluded. A statistical significant basal pain score reduction was observed ((median of the verbal numerical scale (VNS) 7 (p25 = 7; p75 = 8)) compared with 72 h median VNS 4 ((p25 = 3; p75 = 5.3) p = 0.001, and 3 months (median VNS 4 (p25 = 3, p75 = 7)) p = 0.003 after the procedure. Regarding morphine consumption, a statistically significant reduction was observed 3 months after GIB performance (p = 0.012).

Discussion/conclusion

GIB is a safe and easy-to-perform technique achieving satisfactory and statistically significant results, regarding pain control improvement and opioid consumption reduction in patients which meet selection criteria. Prospective, randomized studies with more patients are needed for further conclusions.

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Authors and Affiliations

  1. Department of Anesthesiology, Instituto Português de Oncologia do Porto Francisco Gentil, Porto, Portugal

    Joana Sousa Correia, Manuel Silva, Lina Miranda & Ana Agrelo

  2. Department of Clinical Epidemiology, Instituto Português de Oncologia do Porto Francisco Gentil, Porto, Portugal

    Clara Castro

  3. Pain study and Treatment Department, Instituto Português de Oncologia do Porto Francisco Gentil, Porto, Portugal

    Ana Agrelo

Authors
  1. Joana Sousa Correia
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  2. Manuel Silva
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  3. Clara Castro
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  4. Lina Miranda
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  5. Ana Agrelo
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Correspondence to Joana Sousa Correia.

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Sousa Correia, J., Silva, M., Castro, C. et al. The efficacy of the ganglion impar block in perineal and pelvic cancer pain. Support Care Cancer 27, 4327–4330 (2019). https://doi.org/10.1007/s00520-019-04738-9

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  • DOI: https://doi.org/10.1007/s00520-019-04738-9

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