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Neurolytic abdominal wall blocks with alcohol for intractable gastrostomy site pain in a cancer patient -a case report-

대한마취과학회지 2020년 73권 3호 p.247 ~ 251
이기훈 ( Lee Ki-Hoon ) - National Cancer Center Department of Anesthesiology and Pain Medicine

김대현 ( Kim Dae-Hyun ) - National Cancer Center Department of Anesthesiology and Pain Medicine
김양현 ( Kim Yang-Hyun ) - National Cancer Center Department of Anesthesiology and Pain Medicine
 ( Ro Soo-Han ) - National Cancer Center Department of Anesthesiology and Pain Medicine
 ( Lee Jun ) - National Cancer Center Department of Anesthesiology and Pain Medicine

Abstract


Background: There have been reports of neurolytic transversus abdominis plane (TAP) block using different agents such as alcohol or phenol for the treatment of chronic abdominal pain caused by malignant abdominal wall invasion. However, to date, there have been no reports on neurolytic abdominal wall blocks for pain with non-cancer-related origin in cancer patients.

Case: We performed subcostal TAP neurolysis using ethanol in a patient with esophageal cancer with constant pain at the site of gastrostomy. After neurolysis, the patient’s overall pain decreased, with the exception of pain in the medial part of the gastrostomy site. We performed additional rectus sheath neurolysis using ethanol for the treatment of continuous pain at the medial site, and the effect of neurolysis has persisted for over 4 months.

Conclusions: Alcohol-based TAP neurolysis and rectus sheath neurolysis provide effective pain control in a cancer patient with chronic treatment-related pain involving the abdominal wall.

키워드

Abdominal wall pain; Cancer pain; Neurolytic peripheral block; Rectus sheath block; Regional anesthesia; Transversus abdominis plane block
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