Abstract
Chronic perineal pain syndrome caused by pudendal nerve, is caused by the nerve entrapment between the sacrospinous and sacrotuberous ligaments (interligamentous plane) at the ischial spine and in the Alcock's canal. Pain therapists approach the problem with peripheral nerve blocks. Needle placement is done by a fluoroscopic, computed tomography (CT) or ultrasound (US) guide. The first is unable to visualize the interligamentous plane and it exposes the patient to potentially harmful ionizing radiations. CT scan allows the visualization of the interligamentous space and of Alcock's canal, but it is lacking real-time visual control. US alone ensures real-time needle advancement and confirmation of injective spread within the interligamentous plane but it's usually combined with intraoperative fluoroscopy because at the depth of the ischial spine (usually more than 7. cm) the resolution should be suboptimal. We tried to improve pudendal anesthetic block using fusion real time imaging between US and CT. The system combines, in real time, US imaging with previous magnetic resonance (MR) or CT data. Imaging fusion is possible through the identification of anatomical landmarks of the same patient obtained by the different imaging modalities. Fusion imaging could help to avoid multiple exposures to ionizing radiations, improving costs and quality. We decided to verify the potential of this technique, normally employed to guide interventional imaging, to peripheral anesthetic block, testing its feasibility.
| Original language | English |
|---|---|
| Pages (from-to) | 329-333 |
| Number of pages | 5 |
| Journal | European Journal of Pain Supplements |
| Volume | 4 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - Nov 2010 |
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Keywords
- Ultrasound
ASJC Scopus subject areas
- Anesthesiology and Pain Medicine
Cite this
Feasibility of pudendal nerve anesthetic block using fusion imaging technique in chronic pelvic pain. / Zacchino, Michela; Allegri, Massimo; Canepari, Mario; Minella, Cristina E.; Bettinelli, Silvia; Draghi, Ferdinando; Calliada, Fabrizio.
In: European Journal of Pain Supplements, Vol. 4, No. 4, 11.2010, p. 329-333.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Feasibility of pudendal nerve anesthetic block using fusion imaging technique in chronic pelvic pain
AU - Zacchino, Michela
AU - Allegri, Massimo
AU - Canepari, Mario
AU - Minella, Cristina E.
AU - Bettinelli, Silvia
AU - Draghi, Ferdinando
AU - Calliada, Fabrizio
PY - 2010/11
Y1 - 2010/11
N2 - Chronic perineal pain syndrome caused by pudendal nerve, is caused by the nerve entrapment between the sacrospinous and sacrotuberous ligaments (interligamentous plane) at the ischial spine and in the Alcock's canal. Pain therapists approach the problem with peripheral nerve blocks. Needle placement is done by a fluoroscopic, computed tomography (CT) or ultrasound (US) guide. The first is unable to visualize the interligamentous plane and it exposes the patient to potentially harmful ionizing radiations. CT scan allows the visualization of the interligamentous space and of Alcock's canal, but it is lacking real-time visual control. US alone ensures real-time needle advancement and confirmation of injective spread within the interligamentous plane but it's usually combined with intraoperative fluoroscopy because at the depth of the ischial spine (usually more than 7. cm) the resolution should be suboptimal. We tried to improve pudendal anesthetic block using fusion real time imaging between US and CT. The system combines, in real time, US imaging with previous magnetic resonance (MR) or CT data. Imaging fusion is possible through the identification of anatomical landmarks of the same patient obtained by the different imaging modalities. Fusion imaging could help to avoid multiple exposures to ionizing radiations, improving costs and quality. We decided to verify the potential of this technique, normally employed to guide interventional imaging, to peripheral anesthetic block, testing its feasibility.
AB - Chronic perineal pain syndrome caused by pudendal nerve, is caused by the nerve entrapment between the sacrospinous and sacrotuberous ligaments (interligamentous plane) at the ischial spine and in the Alcock's canal. Pain therapists approach the problem with peripheral nerve blocks. Needle placement is done by a fluoroscopic, computed tomography (CT) or ultrasound (US) guide. The first is unable to visualize the interligamentous plane and it exposes the patient to potentially harmful ionizing radiations. CT scan allows the visualization of the interligamentous space and of Alcock's canal, but it is lacking real-time visual control. US alone ensures real-time needle advancement and confirmation of injective spread within the interligamentous plane but it's usually combined with intraoperative fluoroscopy because at the depth of the ischial spine (usually more than 7. cm) the resolution should be suboptimal. We tried to improve pudendal anesthetic block using fusion real time imaging between US and CT. The system combines, in real time, US imaging with previous magnetic resonance (MR) or CT data. Imaging fusion is possible through the identification of anatomical landmarks of the same patient obtained by the different imaging modalities. Fusion imaging could help to avoid multiple exposures to ionizing radiations, improving costs and quality. We decided to verify the potential of this technique, normally employed to guide interventional imaging, to peripheral anesthetic block, testing its feasibility.
KW - Ultrasound
UR - http://www.scopus.com/inward/record.url?scp=78149357767&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=78149357767&partnerID=8YFLogxK
U2 - 10.1016/j.eujps.2010.09.021
DO - 10.1016/j.eujps.2010.09.021
M3 - Article
AN - SCOPUS:78149357767
VL - 4
SP - 329
EP - 333
JO - European Journal of Pain Supplements
JF - European Journal of Pain Supplements
SN - 1754-3207
IS - 4
ER -