Improvement in the symptoms of anterior cutaneous strangulation syndrome after ultrasound-guided m-TAPA block and trigger point block

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  • modified Thoraco Abdominal nerves through Perichondrial Approach（m-TAPA）ブロックとトリガーポイントブロックの併用で前皮枝神経絞扼症候群の症状が改善した1例

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Abstract

<p>Anterior cutaneous nerve entrapment syndrome (ACNES) is a known cause of chronic abdominal pain. We experienced a case of ACNES improved by an ultrasound-guided block. The patient was a 41-year-old man. He had persistent pain in the upper left abdomen was diagnosed with ACNES and visited our department. Ultrasound image revealed an high-intensity region in the rectus abdominis muscle. Immediately after performing the modified thoraco abdominal nerves through perichondrial approach block (m-TAPA block), the pain improved with NRS 4 to 0/10. In addition, mepivacaine and dexamethasone was injected around the high-intensity region. No recurrence of symptoms was observed even after one and a half months. The high-intensity region in image was the strangulation part of the anterior cutaneous branch of the intercostal nerve that caused ACNES. Both ultrasound guided trigger point block and m-TAPA block were contributed to the improvement of abdominal wall pain.</p>

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