Evaluation of sustained responses to infiltration of local anesthetic in patients with chronic abdominal wall pain
DOI:
https://doi.org/10.22516/25007440.364Keywords:
Pain, infiltration, sustained response, Carnett’s signAbstract
Introduction: Chronic abdominal pain is frequently encountered at outpatient clinics where the traditional approach is to investigate visceral pathologies. Fifty percent of these patients are finally found to have abdominal wall pain which is generally secondary to entrapment of the anterior cutaneous nerve. This entity is identified by Carnett’s sign. The treatment of choice is to infiltrate the painful points with lidocaine following which there is significant improvement in 85% to 90% of these patients. The duration of post-infiltration improvement is unknown. The objective of this work is to determine sustained response in one and two-year follow-up examinations.
Materials and Methods: This is a retrospective cohort study conducted in the gastroenterology unit of the Clínica Fundadores. We included adult patients over 18 years of age who had received local injection treatment with 2% lidocaine without epinephrine and who had answered a telephone survey to assess the intensity of pain on an analogous scale.
Results: Of the 360 eligible patients identified, 324 patients (90%) were interviewed by telephone. The average age of those interviewed was 57 years, and 87% were women. The average pain level prior to infiltration was 8.7 points. Following infiltration, the average intensity was 2.38 points (p <0.05). In 71% of patients, average pain intensity at a two year follow-up examination was 1.65 points (p <0.05), an 81% improvement in intensity (p = 0.001). Fibromyalgia had a positive association with sustained improvement in pain (p = 0.008).
Conclusions: Infiltration of the abdominal wall with a local anesthetic produces a sustained response for up to two years in patients with chronic abdominal wall pain.
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