ULTRASOUND-GUIDED SUPERIOR HYPOGASTRIC PLEXUS NEUROLYSIS IN BLADDER CANCER PATIENTS
Asmaa E. Khalil, Khaled A. Mostafa, Ikram H. Mahmoud, Dina N. Abbas, Mamdouh M. Mostafa, and
Ahmed M. Soliman
Department of Anesthesia, ICU, and Pain Management, National Cancer Institute, Cairo University
Purpose: Patients with advanced bladder cancer frequently experience severe pelvic pain. Often, it is resistant to standard pharmaceutical treatments. This study evaluated the effectiveness of superior hypogastric plexus block (SHPB) with ultrasound guidance (USG) in treating patients with bladder cancer who have intractable pain.
Methods: The study involved 23 patients with stage 3 or 4 bladder cancer scheduled for SHPB for pain management. Following the procedure, the patients' pain level, daily morphine intake, and quality of life (QoL) were evaluated again after a day, a week, a month, and even longer. The Numerical Rating Scale (NRS) was used to assess pain, and the Short-Form Health Survey (SF-36) was used to evaluate quality of life.
Results: The procedure failed in one patient, who was excluded and replaced. The mean procedure time was 16.7±5.8 minutes. NRS scores and daily morphine consumption decreased significantly from one day to 3 months. The pain intensity was reduced by 70% after 1 month and by 61% after 3 months. QoL improved significantly after 1 and 3 months.
Conclusion: For patients with advanced bladder cancer, ultrasound-guided SHPB is a safe and effective analgesic technique for treating severe pelvic pain. It enhances quality of life while lowering morphine intake and pain intensity.
Accepted April 2022
June 2022