Technique of Inferior Hypogastric Block

Multiple approaches, such as lateral, prone, and lithotomy have been described (Figure 9-4.5).3 The most frequently used approach is the prone position. The sacrococcygeal area is prepped and draped in a sterile manner. The entry site, just under the tip of the coccyx, is anesthetized with lidocaine 0.5% using a 25-gauge needle. A 22-gauge, 3.5-in spinal needle is bent into a C shape (commercial C shape 22-gauge, 3.5-in spinal needles are also available). At the site of entry, just under the coccyx, the needle is advanced in a semicircular manner under fluoroscopy (lateral view) until the top of the needle is just anterior to the sacrococ-

Figure 9-4.3. AP view of superior hypogastric block.
Figure 9-4.4. Anatomy of ganglion impar. (Reprinted from Raj PP, Lou L, Erdine S, et al. Radiographic Imaging for Regional Anesthesia and Pain Management,p 238,Copy-right 2003, with permission from Elsevier.)
Figure 9-4.5. Lateral view of inferior hypogastric block.

cygeal junction. After a negative blood aspiration, a radio-opaque dye is injected (1-2mL) and the spread is viewed both in AP and lateral views. There should be a smooth contrast of the dye in the retroperitoneum between the sacrococcygeal region and the rectal bubble. After a negative blood aspiration, a total of 12 to 15mL of bupivacaine

0.375. is injected with intermittent aspirations.

Was this article helpful?

0 0
Biofeedback Mastery

Biofeedback Mastery

Have you ever wondered what Biofeedback is all about? Uncover these unique information on Biofeedback! Are you in constant pain? Do you wish you could ever just find some relief? If so, you are not alone. Relieving chronic pain can be difficult and frustrating.

Get My Free Ebook


Post a comment