{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T00:18:40Z","timestamp":1770509920296,"version":"3.49.0"},"reference-count":29,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,7,6]],"date-time":"2017-07-06T00:00:00Z","timestamp":1499299200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pain Practice"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Superior hypogastric plexus block (<jats:styled-content style=\"fixed-case\">SHGPB<\/jats:styled-content>) is technically difficult, and an accurate procedure is required to avoid potential complications. We attempted to determine the reference angles for fluoroscopy\u2010assisted <jats:styled-content style=\"fixed-case\">SHGPB<\/jats:styled-content> and to establish a predictor as a guide to select the optimal approach between the classic posterior approach and transdiscal approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Abdominopelvic computed tomography (<jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content>) scans from 268 patients diagnosed with pelvic malignancies were examined. The oblique and axial angles needed for the fluoroscope were measured both for posterior and transdiscal approaches by simulating the needle trajectory on <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content> imaging. We developed an <jats:styled-content style=\"fixed-case\">SHGPB<\/jats:styled-content> index defined by the ratio (%) of the interposterior iliac border distance to the L5 body transverse diameter, which represents the relative transverse diameter of the bony pelvis. We evaluated whether it can help select the optimal approach for the <jats:styled-content style=\"fixed-case\">SHGPB<\/jats:styled-content> between the posterior and transdiscal approaches.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Males had a significantly smaller angle than females (right oblique angle for posterior approach, males 14 [range 12 to 17] degrees vs. females 19 [range 16 to 23] degrees; <jats:italic>P<\/jats:italic> &lt; 0.001). An <jats:styled-content style=\"fixed-case\">SHGPB<\/jats:styled-content> index of &lt; 150 was an independent predictor for failure of the classic posterior approach (odds ratio 31.3, 95% confidence interval 5.1 to 104.7).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The optimal right oblique angle of fluoroscopy for the posterior approach is 13\u00b0 to 15\u00b0 in males and 19\u00b0 to 20\u00b0 in females. The transdiscal approach may be favored over the posterior approach when the bony pelvis is narrow relative to the target vertebral body, which can be measured by the <jats:styled-content style=\"fixed-case\">SHGPB<\/jats:styled-content> index being &lt; 150.<\/jats:p><\/jats:sec>","DOI":"10.1111\/papr.12603","type":"journal-article","created":{"date-parts":[[2017,5,18]],"date-time":"2017-05-18T15:51:31Z","timestamp":1495122691000},"page":"314-321","source":"Crossref","is-referenced-by-count":13,"title":["The Optimal Approach for a Superior Hypogastric Plexus Block"],"prefix":"10.1111","volume":"18","author":[{"given":"Ji Won","family":"Choi","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Won Ho","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine Seoul National University Hospital Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chul Joong","family":"Lee","sequence":"additional","affiliation":[{"name":"Zeropain Pain Management Clinic Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Woo Seog","family":"Sim","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sukhee","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hyun Byung","family":"Chae","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine Samsung Medical Center Sungkyunkwan University 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