الفهرس 
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Abstract
Ganglion impar is a unique sympathetic ganglion that is located behind the rectum directly in front of the coccyx or around the sacrococcygeal joint and represents the nociception station of the perineal region. Ganglion impar block applied for the pelvic and perineal pain treatment. Nowadays, there is an increasing interest in the intervention as a primary chronic pelvic pain treatment maneuver. Our study aimed to compare the effect of administration of ketorolac versus dexamethasone on CT guided ganglion impar block with ethyl alcohol in patients with the pelvic tumor. This is a double-blinded randomized controlled clinical trial that included 120 patients of either sex aged between 20 to 70 years old with cancer-related pelvic pain, perineal pain or both, which was conducted in the Oncology Center of Mansoura University (OCMU).
Patients were randomly allocated to one of three groups (a convenient sample of 40 patients each) using the closed envelope method. The study was a phase I clinical trials. group C: patients received a premixed solution of 3 ml lidocaine 2%, 5 ml absolute alcohol 95%- and 4-ml saline in a total volume of 12 ml. group D: patients received a premixed solution of 3 ml lidocaine 2%, 5 ml absolute alcohol 95% and 8 mg dexamethasone with 4 ml saline in a total volume of 12 ml. group K: patients received a premixed solution of 3 ml lidocaine 2%, 5 ml absolute alcohol 95% and 15 mg ketorolac with 4 ml saline in the total volume of 12 ml. There is no statistically significant difference between the studied groups as regard to their age, sex and BMI, heart rate and mean SPO2 changes. A statistically significant difference in mean ABP was recorded in group C at zero, 15 min, 30 min as compared to group D and K. The higher blood pressure was recorded in group D and the lower in group C.The VAS score reduced significantly soon after GIB among the studied groups compared with the pre-injection record and was continued decreasing during all the follow up records. Maximum reduction records of VAS were at 2 months for C, D, K groups and significant pain improvement occurred with VAS score recorded 2-3with marked reduction of analgesic requirements. Our study showed that group C (37patients), 19 patients had complete relief of pain for 3 months, 14 patients for 2 months and 4 patients did not have any symptomatic improvement after GIB. All patients had partial relief of the pain for 6 months. Our study showed that group D (36 patients), 25 patients had complete relief of pain for 4 months, 9 patients for 3 months and 2 patients did not have any symptomatic improvement for GIB. All patients had partial relief of the pain for 6 months. Our study showed that group K (36 patients), 22 patients had complete relief of pain for 4 months, 7 patients for 3 months, 4 for 2 months, and 3 patients did not have any symptomatic improvement for GIB. All patients had partial relief of the pain for 6 months. In conclusion the addition of dexamethasone or ketorolac to absolute alcohol for ganglion impar block for pelvic cancer pain provide a better analgesia with longer duration where dexamethasone in comparison to ketorolac showed a clinical significance without a statistical difference with the addition to alcohol.