Thesis (Ph.D.) - Cairo University - National Cancer Institute - Department of Anaesthesia and Pain Relief

Cancer bladder is the 10th most common cancer in the world , accounts for 3% of global cancer diagnoses and is especially prevalent in the developed world. In the United States, bladder cancer is the sixth most incident neoplasm Pelvic cancer pain is a chronic condition related to the involvement of viscera, pelvic muscular structures or neural structures by tumor. Pain is the most common feature in advanced stages.Cancer pain can be effectively treated in 85{u2013}95% of patients with systematic use of the World Health Organization (WHO) analgesic ladder. However, the chronic use of opioid is generally associated with adverse effects that can reduce the quality of life (QOL) of cancer patients. Visceral pain may be a significant component of advanced stage carcinoma in the pelvis, thereby making the neurolytic block is a useful technique for cancer associated pelvic pain. Neurolytic sympathetic block has been proposed as an effective and relatively simple method for visceral pain . The superior hypogastric plexus is a retroperitoneal autonomic nervous system structure that lies anterior to the caudal third of the L5 and the cephalad third of the S1 vertebral bodies. It includes sympathetic visceral efferents to the pelvic organs from the aortic and lumbar plexi and parasympathetic branches from the sacral outflow tracts

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