Anterior Cutaneous Nerve Block
What is anterior cutaneous nerve block and why do I need this injection?
Abdominal cutaneous nerves (nerves that supply the skin) are branches of the nerves that run under the ribs called intercostal nerves. It supplies the skin of the abdominal wall and might get trapped at the outer border of a muscle called the rectus abdominis muscle – the paired muscle in the front of your abdomen, which when properly exercised gives you the six pack! It might result in chronic abdominal pain - the cause for which none of the abdomen scans pick up - known as the Anterior Cutaneous Nerve Entrapment Syndrome (ACNES). Anterior cutaneous nerve block is considered in patients with a history of chronic abdominal pain where the pain is suspected to originate from the abdominal wall rather than the internal organs.
How is anterior cutaneous nerve block done?
The procedure is usually done on an outpatient basis. Ultrasound is used to identify the abdominal cutaneous nerve and local anaesthetic is injected around the nerve. A positive response confirms the diagnosis of abdominal cutaneous nerve entrapment and can also provide therapeutic benefit lasting weeks to months.
What if pain recurs?
Pulsed radiofrequency treatment can be applied to the abdominal cutaneous nerves for patients whose pain recurs after a positive response to local anaesthetic blocks. Pulsed radiofrequency can provide sustained pain relief in patients with chronic abdominal wall pain or abdominal cutaneous nerve entrapment syndrome (ACNES).
What are the risks associated with this block?
Complications are rare, as injections are performed under ultrasound guidance. Post-procedural pain flare-up for a few days may occur in some patients. Please read our FAQ section to know more about the do's and don'ts prior to and after the procedure.