The Optimal Oblique and Axial Angle of Fluoroscope for Superior Hypogastric Plexus Block

Study Overview
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Brief Summary
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The recommended entry angle for superior hypogastric plexus block is different among references, and there is a need for suggesting a more accurate entry angle for this procedure. The investigators are trying to evaluate the entry angle for superior hypogastric plexus block by measuring these angle on the computed tomography image and apply these angle to the real patients.

Detailed Description
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Superior hypogastric plexus block is a kind of sympathetic plexus block which are used to control the pelvic pain caused by malignancy or other chronic condition. Classic posterior approach for this procedure is inserting the block needle at L4 -5 level and proceed the needle 45 degrees medially and 30 degrees caudally to reach the target of anterolateral space of L5 - S1 intervertebral space. Waldman et al. introduced a different angle of 30 degrees medial and caudal with the same approach, while Stevens et al. recommended 15 degrees medial and 20 degrees caudal. As such, the recommended angle for this procedure is different among references, and there is a need for suggesting a more accurate entry angle for this procedure. Therefore, we are trying to evaluate the entry angle for superior hypogastric plexus block by measuring these angle on the computed tomography image and apply these angle to the real patients.

Official Title
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The Optimal Oblique and Axial Angle of Fluoroscope for Superior Hypogastric Plexus Block

Conditions
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Chronic Pelvic Pain, Pelvic Malignancy, Superior Hypogastric Plexus Block

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Those undergoing abdominopelvic CT scan with pelvic malignancy or chronic pelvic pain with constitutional disease Exclusion Criteria: Poor CT image with non-measurable axial or oblique entry angle

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 80 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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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Pelvic malignancy group<br>those with diagnosis of gynecologic or urologic malignancy | |
| Pelvic chronic disease group<br>those with chronic pelvic pain with constitutional cause e.g. endometriosis | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| the oblique entry angle | the oblique entry angle of superior hypogastric plexus block at L5-S1 level | 1 month after abdominopelvic CT scan performed | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| the axial entry angle | the axial entry angle of superior hypogastric plexus block at L4-S1 level | 1 month after abdominopelvic CT scan performed | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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chronic pelvic pain, superior hypogastric plexus block, pelvic malignancy