Sawada R, Watanabe K, Tokumine J, Lefor AK, Ando T, Yorozu T. Ultrasound-guided rectus sheath block for anterior cutaneous nerve entrapment syndrome after laparoscopic surgery: A case report. World J Clin Cases 2022; 10(7): 2357-2362 [PMID: 35321172 DOI: 10.12998/wjcc.v10.i7.2357]
Corresponding Author of This Article
Joho Tokumine, MD, PhD, Full Professor, Department of Anesthesiology, Kyorin University School of Medicine, 6-20-2 Sinkawa, Mitaka 181-8611, Tokyo, Japan. ii36469@wa2.so-net.ne.jp
Research Domain of This Article
Anesthesiology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Ryuji Sawada, Department of Pain Clinic, NTT Medical Center Tokyo, Higashigotanda 141-8625, Tokyo, Japan
Kunitaro Watanabe, Department of Anesthesiology, Hino Municipal Hospital, Tamadaira 191-0062, Tokyo, Japan
Joho Tokumine, Tadao Ando, Tomoko Yorozu, Department of Anesthesiology, Kyorin University School of Medicine, Mitaka 181-8611, Tokyo, Japan
Alan Kawarai Lefor, Department of Surgery, Jichi Medical University, Shimotsuke 329-0498, Tochigi, Japan
Author contributions: Sawada R and Tokumine J helped in writing the original draft; Watanabe K and Tokumine J helped in the conceptualization of the case report; Lefor AK helped in writing the review and editing the manuscript; Ando T and Yorozu T helped with literature acquisition and data validation.
Informed consent statement: Written informed consent was obtained from the patient for the publication.
Conflict-of-interest statement: The authors declare that they have no competing interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Joho Tokumine, MD, PhD, Full Professor, Department of Anesthesiology, Kyorin University School of Medicine, 6-20-2 Sinkawa, Mitaka 181-8611, Tokyo, Japan. ii36469@wa2.so-net.ne.jp
Received: October 17, 2021 Peer-review started: October 17, 2021 First decision: December 17, 2021 Revised: December 18, 2021 Accepted: January 19, 2022 Article in press: January 19, 2022 Published online: March 6, 2022 Processing time: 135 Days and 17.4 Hours
Abstract
BACKGROUND
Anterior cutaneous nerve entrapment syndrome is defined as abdominal pain due to entrapped intercostal nerves. This is the first report of a patient successfully treated for anterior cutaneous nerve entrapment syndrome after laparoscopic surgery with an ultrasound-guided rectus sheath block. The rectus sheath block physically lysed adhesions and relieved pain from anterior cutaneous nerve entrapment syndrome.
CASE SUMMARY
The patient is a 44-year-old man who presented with severe left upper abdominal pain at an operative scar one month after laparoscopic ulcer repair. Diagnosis and treatment were performed using an ultrasound-guided rectus sheath block with 0.1% lidocaine 20 mL. The pain was relieved after the block. The diagnosis was anterior cutaneous nerve entrapment syndrome. Rectus sheath block may be effective for patients with anterior cutaneous nerve entrapment syndrome.
CONCLUSION
Ultrasound-guided rectus sheath block is a promising treatment modality for patients with postoperative anterior cutaneous nerve entrapment syndrome due to adhesions.
Core Tip: Anterior cutaneous nerve entrapment syndrome (ACNES) is defined as chronic abdominal wall pain caused by entrapment of cutaneous branches of the lower thoracoabdominal intercostal nerves. In the present report, ACNES after a laparoscopic procedure was successfully treated with ultrasound-guided rectus sheath block. Ultrasound-guided rectus sheath block may become an important part of the armamentarium.
