Transversus Abdominis Plane Block as a Treatment Modality for Chronic Abdominal Pain.

BACKGROUND

This study describes the use of transversus abdominis plane (TAP) blocks to treat and manage chronic abdominal pain (CAP) in patients who have exhausted other treatment options. Typically, this is a procedure prescribed for treating acute abdominal pain following abdominal surgery. Here we evaluate the use of TAP blocks for longer relief from CAP.

OBJECTIVES

To assess the efficacy of TAP blocks for pain control in patients with CAP.

STUDY DESIGN

This was a retrospective chart review and analysis of TAP blocks performed over 5 years. This project qualified for institutional review board exemption.

SETTING

This study was completed at an academic institution.

METHODS

We reviewed the charts of 92 patients who received TAP blocks for CAP after previous treatment was ineffective. Some patients underwent multiple TAP blocks, with a total of 163 individual procedures identified. For most blocks, a solution of 0.25% bupivacaine and triamcinolone was injected into the TAP. Efficacy of the injection was measured using pain scores, percent improvement, and duration of relief from pain.

RESULTS

TAP blocks were associated with a statistically significant (P <= 0.05) improvement in abdominal pain scores in 81.9% of procedures. Improvement was 50.3% ± 39.0% with an average duration of 108 days after procedures with ongoing pain relief at time of follow-up were removed. There was a significant reduction in emergency department visits for abdominal pain before and after the procedure (P <= 0.05).

LIMITATIONS

This was a retrospective chart review with lack of a control group.

CONCLUSIONS

TAP blocks can be extrapolated for treating abdominal pain beyond acute settings. TAP injections can be considered as a treatment option for patients with somatosensory CAP refractory to other forms of pain management.

KEY WORDS

Abdominal pain, transversus abdominis plane block, chronic pain, chronic abdominal pain, pain management, somatosensory pain, transversus abdominis plane, steroid injection.