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Year : 2019  |  Volume : 6  |  Issue : 4  |  Page : 433-438

Computed tomography-guided ganglion impar block for management of phantom rectum pain: a randomized controlled trial

1 Department of Anaesthesia, Intensive Care and Pain Management, Mansoura University, Mansoura, Egypt
2 Department of Consultant, General Surgery in Oncology Center, Mansoura University, Mansoura, Egypt
3 Department of Radiology, Faculty of Medicine, Mansoura University, Mansoura, Egypt

Correspondence Address:
MD Nevert A Abdel Ghaffar
Department of Anaesthesia, Intensive Care and Pain Management, Faculty of Medicine, Mansoura University, 35516
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/roaic.roaic_52_19

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Background Patients who undergo abdominoperineal resection with colostomy may experience phantom rectum pain syndrome. Aim To evaluate combined ganglion impar block and pregabaline for treatment of phantom rectum pain syndrome and improvement of quality of life. Settings and design We conducted a randomized prospective open-label blinded end-point level IV trial in a university-affiliated oncology center in Mansoura, Egypt during the period from June 2018 to May 2019. Patients and methods A total of 40 patients were randomly allocated into two groups: group A (n=20) received pregabaline 150 mg twice daily, and group B (n=20) received pregabaline 150 mg twice daily and ganglion impar block using 5 ml bupivacaine 5% with 14 mg/2 ml betamethasone. We monitored numerical rating scale (NRS), participant satisfaction reporting scale, pain anxiety symptoms scale, postblock complication, and success rate of block. Statistical analysis We used χ2, t-test, and Mann–Whitney tests for statistical analysis. Results NRS improved in each group at 1 week, 1, and 2 months in comparison with basal values (within-group P<0.001). NRS decreased in group B in comparison with group A at 1 week (P<0.001) and 1 month (P=0.01). Participant satisfaction reporting scale Q2 and Q5 were better in group B than group A (P=0.02 and 0.049; respectively). Cognition items, anxiety items, and total pain anxiety symptom scale were better in group B than group A (P=0.003, <0.001, and <0.001; respectively). No complications were detected during or after the procedure, and the success rate of the block was 95%. Conclusion Ganglion impar block with pregabaline improved pain and quality of life in patients with phantom rectum pain syndrome.

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