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Korean J Anesthesiol > Epub ahead of print
DOI: https://doi.org/10.4097/kja.19041    [Epub ahead of print]
Published online April 30, 2019.
Neurolytic abdominal wall blocks with alcohol for intractable gastrostomy site pain in a cancer patient
Ki Hoon Lee1, Dae Hyun Kim1, Yang Hyun Kim1, Soo Han Ro2, Jun Lee1
1Department of Anesthesiology and Pain Medicine, National Cancer Center, Goyang, Korea
2Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea
Corresponding author:  Dae Hyun Kim, Tel: 82-31-920-1699, Fax: 82-31-920-1463, 
Email: dhkim@ncc.re.kr
Received: 1 February 2019   • Revised: 12 April 2019   • Accepted: 30 April 2019
Abstract
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. These studies have utilized neurolysis in patients with metastatic colon cancer and abdominal wall metastasis of neuroendocrine tumors. However, to date, there have been no reports on neurolytic abdominal wall blocks for pain with non-cancer-related origin in cancer patients. We performed subcostal TAP neurolysis using ethanol in a patient with esophageal cancer with constant pain at the site of gastrostomy, which was performed as a supportive treatment. 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.


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