Pre-emptive US Guided Superior Hypogastric Plexus Block in Pelvic Cancer Surgeries : a Randomized Double-Blinded Study

Study Overview
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Brief Summary
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The superior hypogastric plexus (SHP) is a retroperitoneal structure with a predominance of afferent sympathetic nerve fibers. The perception of central pelvic pain is thought mainly to involve transmission through this plexus. Therefore, blocking or of SHP has been used to treat pelvic pain.

Detailed Description
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Ultrasound guided superior hypogastric plexus block there is 2 equal groups: Group S (SHPB group 18 patients) ultrasound guided SHPB is done after induction of balanced general anesthesia (fentanyl, propofol and rocuronium) using 20 ml Bupivacaine 0.5% before skin incision, Group C (Control group 18 patients) in which same technique will be done but using normal saline 0.9% instead of bupivacaine. Patients of both groups will receive patient controlled analgesia using morphine with continous background infusion of morphine 1.5 mg/h with adding granisterone 2mg/60 ml and ability to give bolus of 0.5 mg morphine on demand. • Dosing and administration; Group S (SHPB group 18 ultrasound guided SHPB ) using 20 ml Bupivacaine 0.5% before skin incision. Group C (Control group 18 patients) in which same technique will be done but using normal saline 0.9%

Official Title
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Pre-emptive Ultrasound Guided Superior Hypogastric Plexus Block in Pelvic Cancer Surgeries : a Randomized Double-Blinded Study

Conditions
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Analgesia

Intervention / Treatment
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* Procedure: Superior Hypogastric Plexus Block


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: ASA II,III. Patients undergoing pelvic surgeries. Exclusion Criteria: Patients refusal, Coagulopathy, Infection.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Group S (SHPB group 18 ultrasound guided SHPB ) using 20 ml Bupivacaine 0.5% before skin incision. Group C (Control group 18 patients) in which same technique will be done but using normal saline 0.9%
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: ( Group A)<br>ultrasound guided superior hypogastric plexus block using 20 ml Bupivacaine 0.5% before skin incision. | Procedure: Superior Hypogastric Plexus Block<br>* Pre operative ultrasound guided superior hypogastric plexus block in pelvic surgeries using a curvilinear probe below umbalicus with needle in plane technique to reach the plexus in front of L5 vertebra<br>|
| Placebo Comparator: (Group B)<br>ultrasound guided superior hypogastric plexus block using 20 ml normal saline 0.9% instead of bupivacaine. | Procedure: Superior Hypogastric Plexus Block<br>* Pre operative ultrasound guided superior hypogastric plexus block in pelvic surgeries using a curvilinear probe below umbalicus with needle in plane technique to reach the plexus in front of L5 vertebra<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| morphine consumption | Total 24 hours morphine consumption in milligrams | baseline till 24 hours postoperative | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Visual analogue scale (VAS) | scale in which 0 is least pain and 10 is sever pain | Visual analogue scale (VAS) at baseline till 24 hours postoperative |