Keywords
pain
pelvic
fluoroscopy.
Abstract
Introduction: Chronic pelvic pain is a common, disabling gynecological problem that affects patient’s quality of life. Its prevalence is estimated to be up to 26.6 % worldwide and in 30 % of the cases there’s no clear trigger. Within the analgesic management, the use of interventionism is proposed as an effective tool, for this reason the cases collected in the Colombian Institute of Pain (Incodol) are analyzed to determine the effectiveness and safety of the procedure. Materials and methods: In this retrospective descriptive study, 100 patients with superior hypogastric plexus block guided by fluoroscopy were analyzed. Data on pain perception and analgesic requirements were obtained at 0, 1, 3, and 6 months after the block, and complications such as bleeding, infection, neurological injury, persistent pain, and toxicity were recorded. Pain perception was analyzed using the generalized linear model with mixed effects for repeated measures. Results: All patients presented visceral pain with a mean baseline perception of 8.4 (SD = 1.5). The perceived pain presented a clinically relevant decrease (> 50 %) of 45 %, 36 % and 23 % for each period and the decrease in analgesic requirement at 1, 3 and 6 months was 20 %, 19 % and 9 % respectively; For the sixth month, the reduction of pain perception was statistically significant, being higher in those who reduced the need for analgesics (-5.2; 95 % CI: -6.7, -3.8). No complications were recorded. Conclusions: The statistically significant reduction at six months in the mean of perceived pain in patients with fluoroscopy-guided superior hypogastric plexus block is documented, without registering associated complications. It is considered beneficial in terms of pain reduction from the perspective of absolute points with respect to baseline VAS value. The safety results give rise to consider it as a complementary and/or rescue technique in selected populations.References
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