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회음부 암성통증에 대한 외톨이 신경절 블록과 상 하복 신경총 블록 : 증례 보고

Other Titles
 Blockade of Ganglion Impar and Superior Hypogastric Plexus Block for Perineal Cancer Pain : Case report 
Authors
 한승연  ;  윤덕미 
Citation
 Korean Journal of Pain (대한통증학회지), Vol.12(2) : 238-241, 1999 
Journal Title
 Korean Journal of Pain (대한통증학회지) 
ISSN
 1226-2579 
Issue Date
1999
Keywords
Pain ; Cancer, perineal, Nerve block ; Ganglion impar, Superior hypogastric plexus
Abstract
Intractable pain arising from disorders of the viscera and somatic structures within the pelvis and perineum often poses difficult problems for the pain pratitioner. The reason for this difficulty is that the region contains diverse anatomic structures with mixed somatic, visceral, and autonomic innervation affecting bladder and bowel control and sexual function. Clinically, sympathetic pain in the perineum has a distinctly vague, burning, and poorly localized quality and is frequently associated with the sensation of urgency. Although various approaches have been proposed for the management of intractable perineal pain, their efficacy and applications are limited. Historically, neurolytic blockade in this region has been focused mainly on somatic rather than sympathetic components. The efficacy of neurolytic ganglion impar block has been demonstrated in treating perineal pain without significant somatovisceral dysfunctions for patient with advanced cancer in 1990. The introduction of superior hypogastric plexus block in 1990 demonstrated its effectiveness in patients with cancer related pelvic pain. In our report, five patients had advanced cancer (rectal caner 3; cervix cancer 1. metastases to sacral portion of renal cell cancer 1). Localized perineal pain was present in all cases and was characterized as burning and urgent with 9~10/10 pain intensity. After neurolytic block of ganglion impar, patients experiened incomplete pain reduction (7~8/10), as determined by the VAS (visual analogue scale), and change in pain site. We then treated with superior hypogastric plexus block, which produced satisfactory pain relief (to less than 4/10), without complication.
Files in This Item:
T199902669.pdf Download
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Yoon, Duck Mi(윤덕미)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/174216
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