Superior Hypogastric Plexus Block – Posterolateral Approach, Coaxial View (Non-transdiscal Approach)

Abstract

Superior hypogastric plexus block and subsequent chemical ablation are commonly performed for cancer pain of the pelvis and occasionally for other chronic intractable pelvic pains. This chapter provides a simple, step-by-step guide on how to perform the posterolateral approach safely and shows all the relevant C-arm and needle positions that need to be demonstrated during the Fellow of Interventional Pain Practice (FIPP) exam administered by the World Institute of Pain (WIP). Both native and edited high-quality images are included, so the fluoroscopy anatomy is more easily understood.

Possible complications of the procedures and common reasons for failure at the FIPP exam are also outlined. Evidence for the procedure is provided based on the available literature reviewed by the Benelux section of WIP and also by the American Society of Interventional Pain Physicians (ASIPP).