title: Subcostal transversus abdominis plane phenol injection for abdominal wall cancer pain.
abstract: A subcostal transversus abdominis plane (TAP) phenol injection was performed on a patient with refractory cancer pain due a metastatic involvement of the abdominal wall. A diagnostic block with local anesthetic was performed under ultrasound guidance (USG), resulting in a decrease of 80% and 100% in dynamic and static visual analog scale (VAS) for pain, respectively, for 20 hours. A phenol injection was then performed under USG. The patient reported 70% and 100% reduction in the dynamic and static VAS for pain and had a 50% decrease in the opioid requirement that was maintained for 2 months. TAP blocks offer an interesting tool for either diagnosis or therapeutic purpose in chronic pain management. USG provides an optimal approach to soft-tissue lesions where fluoroscopy techniques are not useful.
authors.affiliation: Hospital Pablo Tobon Uribe, Department of Surgery, Interventional Radiology & Pain Relief Clinic, Medellin, Antioquia, Colombia; Department of Anesthesia & Pain Clinic, Clinica Las Americas, Medellin, Antioquia,, Colombia.
authors.forename: Carlos Eduardo
authors.initials: CE
authors.lastname: Restrepo-Garces
authors.forename: Juan Francisco
authors.initials: JF
authors.lastname: Asenjo
authors.forename: Carlos Mario
authors.initials: CM
authors.lastname: Gomez
authors.forename: Santiago
authors.initials: S
authors.lastname: Jaramillo
authors.forename: Nathalia
authors.initials: N
authors.lastname: Acosta
authors.forename: Lizeth Jazmin
authors.initials: LJ
authors.lastname: Ramirez
authors.forename: Luz Maria
authors.initials: LM
authors.lastname: Lopera
authors.forename: Juan Felipe
authors.initials: JF
authors.lastname: Vargas
mesh_terms: D000008:Abdominal Neoplasms / Q000150:complications* / Q000556:secondary; D015746:Abdominal Pain / Q000188:drug therapy* / Q000209:etiology; D034861:Abdominal Wall; D002277:Carcinoma / Q000150:complications* / Q000556:secondary; D005260:Female; D006801:Humans; D008875:Middle Aged; D019800:Phenol / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000473:pathology
chemical_list: D019800:Phenol
keywords: TAP block; cancer pain; neurolytic block; phenol; transversus abdominis plane block; ultrasound guidance