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Superior Hypogastric Plexus Block Using a Single Needle and Computed Tomography Guidance: Description of a Modified Technique
  1. Steven D. Waldman, M.D.*,
  2. William L. Wilson, M.D.** and
  3. Randy D. Kreps, M.D.**
  1. From the Pain Consortium of Greater Kansas City, Kansas City, Kansas
  2. *Director, Pain Consortium of Greater Kansas City; Clinical Professor of Anesthesiology, University of Missouri—Kansas City School of Medicine
  3. **Consultant in Pain Management, Pain Consortium of Greater Kansas City


Block of the superior hypogastric plexus has been advocated as a useful technique in the palliation of pain secondary to pelvic malignancies, endometriosis, chronic benign pelvic pain, and proctalgia fugax. Traditionally, this technique has been performed under fluoroscopic guidance using bilateral placement of needles. We describe a modification of that technique that allows successful hypogastric plexus block using a single needle placed under computed tomography guidance. Our experience suggests that computed tomography guidance allows easier, safer, and more accurate needle placement, obviating the need for the placement of the second needle when performing superior hypogastric plexus block.

  • Hypogastric plexus block
  • technique
  • cancer pain
  • sympathetic nervous system
  • hypogastric plexus

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