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Subcostal Transversus Abdominis Plane Phenol Injection for Abdominal Wall Cancer Pain

Pain practice : the official journal of World Institute of Pain | 9 Apr 2013

CE Restrepo-Garces, JF Asenjo, CM Gomez, S Jaramillo, N Acosta, LJ Ramirez, LM Lopera and JF Vargas
Abstract
A subcostal transversus abdominis plane (TAP) phenol injection was performed on a patient with refractory cancer pain due a metastatic involvement of the abdominal wall. A diagnostic block with local anesthetic was performed under ultrasound guidance (USG), resulting in a decrease of 80% and 100% in dynamic and static visual analog scale (VAS) for pain, respectively, for 20 hours. A phenol injection was then performed under USG. The patient reported 70% and 100% reduction in the dynamic and static VAS for pain and had a 50% decrease in the opioid requirement that was maintained for 2 months. TAP blocks offer an interesting tool for either diagnosis or therapeutic purpose in chronic pain management. USG provides an optimal approach to soft-tissue lesions where fluoroscopy techniques are not useful.
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Concepts
Local anesthetic, Vitamin D, Ketamine, Iliohypogastric nerve, Chronic pain, Transversus abdominis muscle, Anesthesia, Pain
MeSH headings
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