Abstract  
	Background and aims: Ganglion impar (GI) block is routinely used for controlling perineal and pelvic  pain in advanced cancer patients in PC Department of CCC – Vratsa. The aim is to analyze effectiveness and safety of temporary GI block by direct trans-sacrococcygeal junction approach and Dogliotti's principle for needle tip placement.  
	Methods – retrospective analysis of medical records of patients who had undergone GI blockade and to analyze recorded data about pain intensity, opioids consumption, numbers of rescue doses, and side effects “before” and “6h; 24h; 72h after” GI block. In patients’ medical records pain intensity was recorded using NRS10, and side effects (if there were any) were recorded as “mild”, “moderate” and “severe” 
	Results: For 5 years (2013-2018) 58 successful and 4 unsuccessful (success rate = 93,5%) blocks were made to 44 patients (32male; 12 female), mean age 66,11y.o. Patients’ diagnoses and pain intensity “before” and “after” blockade are shown on tabl.1. Mean hospital stay was 7,07days. In 9 patients were made 2 and in 3 pts. – 3 blockades per hospitalization. Average interval between blocks in patients with more than one block per hospitalization was 4.32 days (≥2 ≤12) In one patient (ICD10- C21.1) 5 blockades were made for 40days. In 4 pts periods between blockades were > 6 months, in two > 1 year; usual interval was 4-6 weeks. Data analysis reveal mean reduction of pain intensity score (35.26% less “72 h after” vs “before”) (p<0.05), the number of rescue doses, and reduction of opioid consumption in all patients (p<0.05) No serious adverse reactions were observed. 
	Conclusions: Data analysis reveal that GI block is effective and safe procedure for controlling perineal pain in advanced cancer patients.

TRANS-SACROCOCCYGEAL JUNCTION BLOCK OF GANGLION IMPAR FOR PERINEAL PAIN CONTROL IN ADVANCED CANCER PATIENTS