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Abdominal Cutaneous Nerve Entrapment block

Abdominal Cutaneous Nerve Entrapment is a common source of pain that we have discussed here, and a link to a good article about this is below.  One of the things that can help this pain is the injection of a small amount of local anaesthetic and locally acting steroid around the nerve where it is trapped, which is normally at the outer edge of the rectus muscle ("six-pack") where the nerve passes through the muscle and its surrounding sheath.

In addition to this, other nerves in the abdominal wall such as the genitofemoral nerve and ilioinguinal nerve can be trapped as they pass through the abdominal wall, and similarly the pain resulting from this can respond to injections.

To do this, the skin is sterilised and then a small dose of local anaesthetic is injected with a very fine needle to numb the skin, and then (either by touch or sometimes with the help of an ultrasound machine) a fine needle with a slightly flattened tip is placed onto the outer part of the sheath.  When the point of discomfort is identified the needle is advanced through the sheath and the drugs are injected around the nerve.  

Normally, although there is a short twinge of discomfort (which, if it happens, is actualy encouraging because it confirms that the injection is in precisely the right place) and then almost immediately the pain is more comfortable.

Afterwards, patients stay for a short period to ensure that they have no immediate ill-effects and then go home shortly afterwards.

(Please see general comments on the Procedures page)

You can download our Pain Service's information sheet on this procedure from this link.

 

Links

A site on Abdominal Cutaneous Nerve Entrapment which, although written for doctors, many of our patients find both comprehensible and very useful is here.

  

 

 

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Pain Service Website, Gloucestershire Hospitals NHS Foundation Trust
Webmaster Dr J G de Courcy, Consultant in Pain Medicine and Anaesthesia
email: pain.webmaster[at]glos.nhs.uk

Page updated 22/6/2016