Brain injury prediction using the translational energy criterion: an experimental study. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Pedestrian impact: baseline and preliminary concepts evaluation, volume II - technical discussion. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Analysis of head response to torso acceleration. Volume I - development of performance requirements. Final report.

Transportation Systems Center, Cambridge, Mass.

Analysis of head response to torso acceleration. Volume II - description of data retrieval, analysis and display software. Final report.

Transportation Systems Center, Cambridge, Mass.

Quantification of occupant response and injury from impact. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Experimental pedestrian accident reconstructions - head impacts. Final report.

Mode of access: Internet.

Pedestrian impact: baseline and preliminary concepts evaluation, volume I - summary. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Injury study of the femur-pelvic complex in automobile crash environment. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Computer simulation of human thoracic skeletal response - volume I, theory.

National Highway Traffic Safety Administration, Washington, D.C.

Computer simulation of human thoracic skeletal response - volume II, THORAX programmer's and user's manual. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Response of belted dummy and cadaver to side impact. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Head and neck injury seminar.

Mode of access: Internet.

Response of cadaver test subjects in belt restraints. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Response of belted dummy and cadaver to rear impact. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Inferior Hypogastric Plexus Block Affects Sacral Nerves and the Superior Hypogastric Plexus

Background. The inferior hypogastric plexus mediates pain sensation through the sympathetic chain for the lower abdominal and pelvic viscera and is thought to be a major structure involved in numerous pelvic and perineal pain syndromes and conditions. Objectives. The objective of this study was to demonstrate the structures affected by an inferior hypogastric plexus blockade utilizing the transsacral approach. Study Design. This is an observational study of fresh cadaver subjects. Setting. The cadaver injections and dissections were performed at the Department of Forensic Sciences and Insurance Medicine, Semmelweis University, Budapest, Hungary after obtaining institutional review board approval. Methods. 5 fresh cadavers underwent inferior hypogastric plexus blockade with radiographic contrast and methylene blue dye injection by the transsacral fluoroscopic technique described by Schultz followed by dissection of the pelvic and perineal structures to localize distribution of the indicator dye. Radiographs demonstrating correct needle localization by contrast spread in the specific tissue plane and photographs of the dye distribution after cadaver dissection were recorded for each subject. Results. In all cadavers the dye spread to the posterior surface of the rectum and the superior hypogastric plexus. The dye also demonstrated distribution to the anterior sacral nerve roots of S1, 2, and 3 with bilateral spread in 3 cadavers and ipsilateral spread in 2 of them. Limitations. The small number of cadaver specimens in this study limits the results and generalization of their clinical significance. Conclusions. Inferior hypogastric plexus blockade by a transsacral approach results in distribution of dye to the anterior sacral nerve roots and superior hypogastric plexus as demonstrated by dye spread in freshly dissected cadavers and not by local anesthetic spread to other pelvic and perineal viscera.