One hundred nine patients , with inoperable abdominal or pelvic cancer , reporting visceral pain of @-@ on a visual analogue scale and taking nonopioid analgesics were allocated randomly into two groups : either blocks were performed before Step @ of the WHO ladder , then analgesics were managed according to the ladder ( Group I ) or analgesics were given according to the WHO ladder , and blocks were performed as the fourth step after failure of strong opioids to control pain ( Group II ) .