Superior hypogastric plexus and ganglion impar block Book Section
| Authors: | Gulati, A.; Bhatnagar, S.; Rakesh, N.; Yousefi, A.; Hernandez-Porras, C. |
| Editors: | Jankovic, D.; Peng, P. |
| Article/Chapter Title: | Superior hypogastric plexus and ganglion impar block |
| Abstract: | The superior hypogastric plexus is located on the surface of L5 and S1 vertebrae, inferior to the bifurcation of the aorta, and carries visceral afferent fibers. The plexus can be blocked for pelvic pains with malignant origin or when treatment related side effects, such as radiation and scar tissue formation, result in reproduction of pain in the pelvis. The best percutaneous approach for blocking the ganglion is dorsal to the vertebral body and under fluoroscopic guidance. The ganglion can be blocked with local anesthetics and steroids. Neurolysis is achieved by ethyl alcohol or phenol. The procedure may result in complications such as pelvic organ damage, bleeding, or nerve injury. The ganglion of impar is the most caudal ganglion of the sympathetic chain. This ganglion supplies sympathetic and visceral innervation to the lower third of the rectum, vagina, vulva, urethra, and coccyx. The ganglion of impar can be targeted for relieving visceral pain caused by neoplasms of the lower pelvic structures or surgical or radiation induced pain in the area. Coccydynia, or other benign processes that cause pain in the perineal area, can also be treated with this procedure. The procedure is relatively safe with minimal complications. Possible complications include rectal perforation, discitis, and sacral nerve root blockade. Fluoroscopic or CT image-guided blockade is used to minimize these complications. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2015, 2022, corrected publication 2022. |
| Keywords: | cancer pain; rectal pain; pelvic pain; coccydynia; ganglion impar; superior hypogastric |
| Book Title: | Regional Nerve Blocks in Anesthesia and Pain Therapy: Imaging-Guided and Traditional Techniques. 5th ed |
| ISBN: | 978-3-030-88726-1 |
| Publisher: | Springer Nature Switzerland Ag |
| Publication Place: | Cham, Switzerland |
| Date Published: | 2022-01-01 |
| Start Page: | 667 |
| End Page: | 672 |
| Language: | English |
| DOI: | 10.1007/978-3-030-88727-8_48 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Book Chapter: 48 -- Source: Scopus |
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