Transversus abdominal plane and rectus sheath block combination for intractable anterior cutaneous nerve entrapment syndrome after severe cholecystitis

Imajo, Yukihiro; Komasawa, Nobuyasu; Fujiwara, Shunsuke; Minami, Toshiaki

doi:10.1016/j.jclinane.2016.01.036

Cited by 11 publications

(13 citation statements)

References 2 publications

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“…The most commonly administered drugs were nonsteroidal anti-inflammatory drugs (NSAIDs) such as paracetamol, weak opioids, and drugs generally used for neuropathic pain management, such as antiepileptics (gabapentin and pregabalin) and antidepressants (mostly amitriptyline) 12. Roderick and Norman13 used amitriptyline and lidocaine patches combined with paracetamol and tramadol, which gave good results, while Imajo et al14 reported the administration of pregabalin, which was only partially effective. Sahoo and Nair15 detailed the administration of NSAIDs, muscle relaxants, tramadol, and gabapentin in two patients, but this did not result in any significant relief.…”

Section: Systemic Drug Administrationmentioning

confidence: 99%

“…Interventional techniques were the main therapeutic option employed in most of the studies on pain management in ACNES 1,2,13,14,17–20. These techniques include the trigger point injections (blind or ultrasound-guided), neurolytic techniques (chemical neurolysis or radiofrequency ablation), surgical techniques (anterior neurectomy and mesh reinforcement), and newer techniques such as botulinum toxin injection and neuromodulation 1,2,10–12…”

Section: Interventional Techniquesmentioning

confidence: 99%

“…In most cases, the injection was given blindly. This type of injection is based on the loss of resistance as the needle passes through the aponeurosis of the rectus abdominis,1 but this blind technique may lead to an incorrect placement of the anesthetic, and it also has the risk of entering into the abdominal cavity 14,19,22. More than 50% pain relief is required to confirm the diagnosis, and in some patients, this effect may last for a variable amount of time – usually significantly longer than the actual half-life of the local anesthetic administered 1.…”

Section: Trigger Point Injectionsmentioning

confidence: 99%

“…Finally, yet importantly, Imajo et al14 tried a combination of both rectus sheath block and TAP block in a patient with bilateral ACNES that developed after cholecystitis. The authors used 0.5% mepivacaine without corticosteroid, which provided significant pain relief; however, there are no data on the long-term effect in this patient.…”

Section: Ultrasound-guided Blocksmentioning

confidence: 99%

“…Studies suggest4,6,7,10,11,14,19–20 some specific diagnostic steps to diagnose ACNES, and these include: Unilateral locoregional pain at the abdominal wall lasting for at least 1 monthThe presence of a unilateral tender spot at the abdominal wall (a trigger point of <2 cm 2 fingertip area of maximal tenderness, localized at the lateral border of the rectus abdominis)A positive Carnett’s testA positive skin pinch test and/or altered skin perception to light touch and/or cold at the area of the most intense painNormal laboratory findings with no indication of inflammation or infection, and in the absence of any surgical cause of painNegative imaging of the abdominal wallTemporary positive relief in pain response of at least by 50% after injecting a local anesthetic (usually lidocaine) at the diagnostic trigger point.…”

Section: Introductionmentioning

confidence: 99%

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Anterior cutaneous nerve entrapment syndrome: management challenges

Chrona¹,

Kostopanagiotou²,

Damigos³

et al. 2017

JPR

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Anterior cutaneous nerve entrapment syndrome (ACNES) is a commonly underdiagnosed and undertreated chronic state of pain. This syndrome is characterized by the entrapment of the cutaneous branches of the lower thoracoabdominal intercostal nerves at the lateral border of the rectus abdominis muscle, which causes severe, often refractory, chronic pain. This narrative review aims to identify the possible therapeutic strategies for the management of the syndrome. Seventeen studies about ACNES therapy were reviewed; of them, 15 were case–control studies, case series, or case reports, and two were randomized controlled trials. The presently available management strategies for ACNES include trigger point injections (diagnostic and therapeutic), ultrasound-guided blocks, chemical neurolysis, and surgical neurectomy, in combination with systemic medication, as well as some emerging techniques, such as radiofrequency ablation and neuromodulation. An increased awareness of the syndrome and the use of specific diagnostic criteria for its recognition are required to facilitate an early and successful management. This review compiles the proposed management strategies for ACNES.

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Section: Systemic Drug Administrationmentioning

confidence: 99%

Section: Interventional Techniquesmentioning

confidence: 99%

Section: Trigger Point Injectionsmentioning

confidence: 99%

Section: Ultrasound-guided Blocksmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Anterior cutaneous nerve entrapment syndrome: management challenges

Chrona¹,

Kostopanagiotou²,

Damigos³

et al. 2017

JPR

View full text Add to dashboard Cite

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A cross‐sectional study of anterior cutaneous nerve entrapment syndrome at a Japanese emergency department

Kano,

Komagamine,

Murata

2024

J of Gen and Family Med

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BackgroundAnterior cutaneous nerve entrapment syndrome (ACNES) is the most common cause of abdominal wall pain. This study aimed to clarify the proportion of ACNES cases among those of abdominal pain and the clinical characteristics and prognosis of the disease in an emergency department (ED) of a Japanese general hospital.MethodsThe medical records of patients from January 2014 to December 2023 were reviewed, and patients aged 15 years or older with abdominal pain with positivity for Carnett's sign, a good response to trigger point injection (TPI), and an ACNES diagnosis were included. The proportion of ACNES cases among the complaints related to abdominal pain in the ED between 2020 and 2023 was then determined. The recurrence rate was also determined using data from the medical records and telephone follow‐ups.ResultsTwenty‐one patients were included. Their median age was 50 years (range: 16–83 years), 13 (62%) were female, and 11 (52%) had acute‐onset pain. Follow‐up data were available for 11 patients (52%), seven (64%) of whom had recurrent pain for a median period of 1 week after the index visit. The proportion of ACNES cases among those of abdominal pain was 0.11%.ConclusionACNES might be uncommon among patients with abdominal pain in the ED setting although underdiagnosis of this condition might have led to an underestimation of the proportion of cases. Moreover, given the high recurrence rate of abdominal pain associated with ACNES, following up these patients is very important.

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