Table 1.
The studies reviewed, including authors, year of publication, the number of patients included in the study, the duration and etiology of pain, technique, and drug used, the duration of follow-up period, main outcome measure, complications, and the type of study
| Study | Number of patients | Duration of pain | Technique | Drugs used | Follow-up period | Outcome | Complications | Study type |
|---|---|---|---|---|---|---|---|---|
| Mehta and Ranger,22 1971 | 108 | NS | Chemical neurolysis using a nerve stimulator | Aqueous phenol 5% | 3.5 years | Among the 103 patients with chronic abdominal pain, complete pain relief was reported in 60 patients, partial relief in 33, and no response in 10. At the long-term follow-up, after 3–4 years, relief was sustained in 58 patients | NS | Case series |
| McGrady and Marks,23 1988 | 76 | 1–20 years | Chemical neurolysis using a nerve stimulator | Aqueous phenol 6% | 6 months to 4 years | 42/44 patients with definite ACNES exhibited significant improvement, 16/35 patients with possible ACNES had pain relief after the treatment. | Chemical irritation in four patients | Case series |
| Kanakarajan et al,5 2011 | 9 | 1–7 years | US-guided abdominal cutaneous nerve infiltration | Bupivacaine 0.5% and triamcinolone 40 mg | 12 weeks (11–20) | 6 responders with >50% pain relief | NS | Case series |
| Scheltinga et al,24 2011 | 6 | NS | Surgical neurectomy | 6 months | Pain intensity Nausea, vomiting, daily activities, sports, hobbies (scale 0–4) improved in all children |
NS | Case series | |
| Boelens et al,20 2011 | 139 | In 31% more than 1 year, and 1 of 8 more than 5 years | Surgical neurectomy | Lidocaine 1%, 10 mL injection at diagnostic trigger point | VAS (0–100) and VRS (1–5 from best to worse satisfaction). 94 patients (81%) had significant pain reduction >50% after the first local anesthetic injection, 44 patients were permanently cured, 69 patients had anterior neurectomy, which was successful with 71% having VRS 1–2 | 6 weeks | Cohort | |
| Boelens et al,19 2013 | 48 | 1–120 months | Trigger point injections | 10 mL injection of lidocaine 1% or saline | 20 minutes after injection | VAS (1–100) VRS (0–4) >50% reduction in VAS or >2 points in VRS significantly higher in lidocaine group (13 of 24 versus 4 of 24 in the saline group; P=0·007) |
Small hematoma in one subject | RCT |
| Boelens et al,26 2013 | 44 | 3–120 months | Surgical anterior neurectomy versus sham procedure | 6 weeks | >50% reduction in VAS (0–100) and >2 points reduction in VRS 0–4 in neurectomy group (neurectomy, n=16/22 versus sham, n=4/22; P=0.001) | Localized hematoma (n=5, conservative treatment), infection (n=1, antibiotics and drainage), increased local pain (n=1) | RCT | |
| Batistaki et al,21 2013 | 1 | 2 months | US-guided nerve block, bilaterally | Ropivacaine 0.2% and triamcinolone 20 mg | 2 months | NRS and LANSS improvement (8/18 to 2/12 after treatment) | NS | Case report |
| Nizamuddin et al,16 2014 | 3 | 8 months 12 months 3 months |
US-guided TAP blocks | Lidocaine 1% and triamcinolone 40 mg | 4 months 20 months 2 months |
2 blocks 3 blocks 1 block NRS improvement in all |
NS | Case report |
| Van Assen et al,27 2014 | 41 | NS | Secondary anterior neurectomy (10 patients) or posterior neurectomy (31 patients) after failed anterior neurectomy | 25 months | NRS (0–10) and a 6-point VRS. >50% NRS reduction and/or >2 point VRS reduction was a success in 66% (27/41 patients) |
1 wound abscess (surgical drainage) and 1 wound infection (antibiotics) | Case series | |
| Van Assen et al,28 2015 | 154 patients (181 procedures) | NS | Surgical neurectomy | 32 months (range, 3–93) | Short-term (1–3 months) success was 70% (127/181 procedures). Three patients showed spontaneous remission of complaints after ≥3 months Long-term success rate 61% (109/180) |
10 hematomas 1 seroma 3 abscesses |
Case series | |
| Sahoo and Nair,15 2015 | 2 | 3 months after CS, 7 months after CS | US-guided TAP blocks | Ropivacaine 0.375% and methylprednisolone 20 mg | 12–6 months | >80% pain relief | NS | Case report |
| Stirler et al,29 2016 | 30 | Laparoscopic intraperitoneal mesh reinforcement | mean 54±44 months, range 12–122, median 38) patients’ satisfaction VRS (1–5) | 30 patients underwent laparoscopic intraperitoneal onlay mesh reinforcement. Short- and long-term success rates in 90 (71%) Failure of treatment in five patients |
Late complications occurred in one patient (debilitating pain at the tack fixation points; underwent reoperation) | Cohort retrospective | ||
| Imajo et al,14 2016 | 1 | NS | TAP and rectus sheath block bilaterally | Mepivacaine 0.5% | NS | NRS improvement from 4 to 0 | NS | Case report |
| Triantafyllidis et al,25 2016 | 1 | 13 years | Surgical neurectomy, | 12 months | Pain intensity improvement | None | Case report | |
| Siawash et al,3 2016 | 95 children 12 with ACNES | NS | Trigger point injection and surgical neurectomy in refractory cases | Lidocaine 1% and methylprednisolone 40 mg | Pain intensity improvement in five (with injections) and six with neurectomy. No relief in one |
NS | Case series | |
| Siawash et al,6 2016 | 60 | 1–48 months | Surgical neurectomy | 4–6 weeks | Pain intensity and functional status improvement in 78%, partial improvement in 10% | 1 minimal hematoma | Case series |
Abbreviations: US, ultrasound; CS, cesarean section; TAP, transversus abdominis plane; RCT, randomized controlled trial; NRS, numerical rating scale; ACNES, anterior cutaneous nerve entrapment syndrome; NS, not specified; LANSS, Leeds Assessment of Neuropathic Symptoms and Signs; VAS, visual analogue scale; VRS, verbal rating scale.