We compared the efficacy of Ganglion Impar (GI) block versus Superior Hypogastric Plexus (SHP) with GI block (both combined) for pain relief in patients of pelvic and perineal cancer. This prospective, randomized, double-blinded, controlled study was conducted on 50 patients, 18 to 70 years old with pelvic and perineal cancer pain with  baseline VAS score>5.GI neurolysis with 3-5ml 70% alcohol in one group(group G) and GI along with SHP neurolysis with 10 ml 70% alcohol on either side was done in the other group(group S).VAS score, quality of life (QOL) score by Mcgill’s quality of life questionnaire, requirement of rescue analgesia post-procedure were assessed. The VAS score decreased in both the groups and was lower in group S than in group G, at all intervals except at baseline. QOL also improved in both the groups, the QOL scores being lower in S than G group at all intervals, except at 2 weeks follow up. Rescue analgesic requirement was similar in both the groups except at 2^nd and 3^rd months when morphine consumption was more in GROUP G. Concluded that GI block and GI with SHP block both provide drastic pain relief in pelvic and perineal cancer pain, pain relief being more when SHP is blocked along with GI. Quality of life is improved, and morphine requirement is reduced in both groups (more in group S).

Keywords: Ganglion Impar Block, Superior Hypogastric Plexus Block, Pelvic Cancer, Perineal Cancer, Quality of life questionnaire, visual analog scale.

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Dr Rajesh Raman

Associate Professor, Department of Anesthesiology, King George’s Medical University, Lucknow-226003, Uttar Pradesh, India