Superior hypogastric plexus block as an effective treatment method for endometriosis-related chronic pelvic pain: an open-label pilot clinical trial

Khodaverdi, Sepideh; Alebouyeh, Mardawig; Sadegi, Kambiz; Mehdizadehkashi, Abolfazl; Kaveh, Mania; Entezari, Saeid Reza; Mirzaei, Hossein; Khaledi, Mojdeh; Khodaverdi, Maryam

doi:10.1080/01443615.2020.1820468

Cited by 17 publications

(8 citation statements)

References 23 publications

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“…Non-medical endometriosis treatments include antioxidants [ 21 ], Chinese herbal medicines [ 22 , 23 ], acupuncture [ 24 ], reflexology, homeopathy, psychotherapy, exercise and sports and nerve blocks such as a superior hypogastric plexus block [ 25 ].…”

Section: Introductionmentioning

confidence: 99%

Physiotherapy Management in Endometriosis

Wójcik¹,

Szczepaniak

Placek

2022

IJERPH

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Endometriosis is a disease whose underlying cause is the growth of the endometrium outside the uterine cavity. The disease is characterised by unpleasant pain in the pelvic region, irrespective of the phase of the woman’s cycle. Physiotherapy in its various forms can be an excellent complement to the gynaecological treatment of endometriosis, by virtue of reducing inflammation, alleviating pain and thus significantly improving women’s quality of life. Physiotherapy in endometriosis should include kinesiotherapy, manual therapy including visceral therapy, physical therapy, spa treatment including balneotherapy, and hydrotherapy. The aim of this study is to present the use of physiotherapy as an adjunct therapy in the treatment of endometriosis. A review of the available literature in the Medline, PubMed and Google Scholar databases was performed without being limited by the time frame of available publications on the forms of physiotherapy used in the treatment of endometriosis.

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Section: Introductionmentioning

confidence: 99%

Physiotherapy Management in Endometriosis

Wójcik¹,

Szczepaniak

Placek

2022

IJERPH

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“…Several lines of investigations documented the analgesic benefits of SHP to patients with enduring pelvic pain, inclusive of malignant- (e.g., cancer) and benign (e.g., endometriosis)-related etiologies [ 6 , 22 ]. Within the fields of obstetrics and gynecology, SHP block has been displayed to adequately control postsurgical pain among women undergoing cesarean section [ 23 , 24 ], uterine artery embolization [ 25 ], and laparoscopic hysterectomy [ 26 , 27 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

Analgesic Efficacy of Intraoperative Superior Hypogastric Plexus (SHP) Block during Abdominal Hysterectomy: A Systematic Review and Meta-Analysis of Controlled Trials

et al. 2023

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Background and Objectives: Abdominal hysterectomy is a major surgery that is often associated with pronounced postsurgical pain. The objective of this research is to conduct a systematic review and meta-analysis of all randomized controlled trials (RCTs) and nonrandomized comparative trials (NCTs) that have surveyed the analgesic benefits and morbidity of intraoperative superior hypogastric plexus (SHP) block (intervention) compared with no SHP block (control) during abdominal hysterectomy. Materials and Methods: The Cochrane Central Register of Controlled Trials (CENTRAL), Google Scholar, Web of Science, PubMed, Scopus, and Embase were searched from inception until 8 May 2022. The Cochrane Collaboration tool and Newcastle–Ottawa Scale were used to evaluate the risk of bias of RCTs and NCTs, respectively. In a random effects mode, the data were pooled as risk ratio (RR) or mean difference (MD) with 95% confidence interval (CI). Results: Five studies (four RCTs and one NCT) comprising 210 patients (SHP block = 107 and control = 103) were analyzed. The overall postsurgical pain score (n = 5 studies, MD = −1.08, 95% CI [−1.41, −0.75], p < 0.001), postsurgical opioid consumption (n = 4 studies, MD = −18.90 morphine milligram equivalent, 95% CI, [−22.19, −15.61], p < 0.001), and mean time to mobilization (n = 2 studies, MD = −1.33 h, 95% CI [−1.98, −0.68], p < 0.001) were significantly decreased in the SHP block group contrasted with the control arm. Nevertheless, there was no significant variance between both arms regarding operation time, intraoperative blood loss, postsurgical NSAID consumption, and hospital stay. There were no major side effects or sympathetic block-related aftermaths in both groups. Conclusions: During abdominal hysterectomy and receiving perioperative multimodal analgesia, the administration of intraoperative SHP block is largely safe and exhibits better analgesic effects compared to cases without administration of SHP block.

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“…It is clear from the studies discussed above that a personalized medicine approach to EAP will be essential to reduce the time to successful treatment and the harm associated with unsuccessful therapeutic approaches. Although some recent studies have stratified/excluded participants on the basis of stage of endometriosis [39][40][41][42][43] or BMI [44], to date, no studies have stratified on the basis of pain characteristics. Questionnaire measures and potentially psychophysical assessments may help to identify underlying pain mechanisms and thus inform clinical trial design [45].…”

Section: Future Workmentioning

confidence: 99%

Endometriosis – a painful disease

Coxon,

Evans,

Vincent

2023

Current Opinion in Anaesthesiology

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Purpose of review This review looks to overview advances in endometriosis-associated pain, both in understanding the pain mechanisms involved and increasing treatment options with well designed clinical trials and meta-analyses. Recent findings Our understanding of endometriosis-associated pain has progressed from a purely nociceptive model to an awareness that both neuropathic and nociplastic mechanisms can be present for some people with endometriosis. Clinical trials and meta-analyses have demonstrated efficacy of surgical treatments and hormonal therapies. It is notable that currently, the basic science and clinical trials are not cross-fertilising. Summary Following growth in other areas of chronic pain, there have been significant advances in our understanding of endometriosis-associated pain. However, there remains lots to explore and we are currently a long way from our goal of timely personalized holistic multidisciplinary treatment for all sufferers of endometriosis-associated pain.

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Superior hypogastric plexus block as an effective treatment method for endometriosis-related chronic pelvic pain: an open-label pilot clinical trial

Cited by 17 publications

References 23 publications

Physiotherapy Management in Endometriosis

Physiotherapy Management in Endometriosis

Analgesic Efficacy of Intraoperative Superior Hypogastric Plexus (SHP) Block during Abdominal Hysterectomy: A Systematic Review and Meta-Analysis of Controlled Trials

Endometriosis – a painful disease

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