Efficacy of Transversus Abdominis Plane Steroid Injection for Treating Chronic Abdominal Pain.

Abstract

Historically, transversus abdominis plane (TAP) block has been performed to treat acute abdominal pain that accompanies a variety of surgical procedures. This study represents an innovative approach in which the TAP block was performed on patients experiencing chronic abdominal pain who had failed other forms of pain management. To evaluate the efficacy of the TAP block procedure in patients experiencing chronic abdominal pain. In this retrospective chart review and data analysis, we reviewed the charts of 30 chronic abdominal pain patients previously treated with 45 TAP blocks after other forms of pain management had failed. We examined demographic data, surgical history, medication use, improvement following each block, and the side on which the procedure was performed. In unilateral blocks, 8 mL bupivacaine 0.25% mixed with 40 mg triamcinolone was injected. In bilateral blocks, 9 mL bupivacaine 0.25% and 40 mg triamcinolone were injected on each side. Analgesic efficacy was assessed via improvement in pain levels before and after the procedure was performed. Transversus abdominis plane block improved pain in 79.5% of the performed blocks. The percentage improvement was 54.7% ± 36.4% for an average of 84 ± 108 (0 to 490) days for the 44 procedures with complete data. There was significant reduction in the use of gabapentin before and after the procedure (P < 0.05). Transversus abdominis plane steroid injection can be a helpful in treating somatosensory chronic abdominal pain resistant to other therapeutic modalities.