Pain physician
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The superior hypogastric plexus (SHGP) carries afferents from the viscera of the lower abdomen and pelvis. Neurolytic block of this plexus is used for reducing pain resulting from malignancy in these organs. The ganglion impar (GI) innervats the perineum, distal rectum, anus, distal urethra, vulva, and distal third of the vagina. Different approaches to the ganglion impar neurolysis have been described in the literature. ⋯ A combined neurolytic SHGP block with GI block is an effective and safe technique for reducing pain in cancer patients presented with pelvic and/or perineal pain. Also, a combined SHGP block through a posteromedian transdiscal approach with a GI block through a trans-sacrococcygeal approach may be considered more effective and easier to perform than the recently invented bilateral inferior hypogastric plexus neurolysis through a transsacral approach.
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We previously published on the pressure effect using a rheumatoid animal model (Pain Physician in 2013 and 2014). However, we do not know how long the pressure effect lasts after exposure to high pressure. ⋯ The 3 hours of 1.5 ATA pressure effect lasted for more than a day. Longer pressure exposure time appears to yield a greater therapeutic effect in an RA animal model up to a given study period. Continuous application of high pressure might be beneficial for achievement of a better therapeutic effect in clinical application.