Abdominal wall block treatment in management of chronic abdominal pain

  • Research type

    Research Study

  • Full title

    Effectiveness of Abdominal Plane Block (APB) treatment in the management and preventing recurrent hospital admissions in patients presenting with acute exacerbation of chronic abdominal pain (CAP): an Observational Pilot Study

  • IRAS ID

    256714

  • Contact name

    Niraj Gopinath

  • Contact email

    nirajgopinath@yahoo.co.uk

  • Sponsor organisation

    University Hospitals of Leicester NHS Trust

  • Duration of Study in the UK

    3 years, 0 months, 1 days

  • Research summary

    Summary of Research
    Background: Chronic (longstanding) Abdominal Pain (CAP) is the sixth most common cause of hospital admission from any cause in women and the tenth most common cause in men. In the UK, it has been estimated that non-specific abdominal pain costs the economy in excess of £100 million per annum. The mechanism of chronic abdominal pain is poorly understood. Patients with acute exacerbation of their longstanding abdominal pain have multiple hospital admissions, prolonged length of stay and utilise significant health care resources. These patients have undergone multiple investigations with negative results leading to frustration for both the patient and the clinician. Additional testing and investigations increases costs, patient morbidity and comes with added risks. Patients are discharged once the flare up settles. We have shown that treating patients with steroid injection followed by heat treatment (pulsed radiofrequency treatment) six months later can reduce the length of stay, repeat hospital admission, improve mood and provide durable pain relief in patients with CAP. The steroid medication is injected into a specific area (plane) in the abdominal wall of the patient and is called abdominal plane block (APB). We currently offer ABP treatment as a standard treatment in the management of patients with APB who are admitted to the hospital (in-patients) as well as those who are seen as outpatients in the clinic.
    Aim of the study is to evaluate the effectiveness of Abdominal Plane Block (APB) treatment in reducing hospital readmission over 12 months in patients admitted with exacerbation of Chronic Abdominal Pain (CAP)
    Methods: The proposed study is a prospective, observational pilot study that will be conducted at Leicester General Hospital over 36 months. After providing written consent, adult patients admitted to the hospital with acute exacerbation of their longstanding abdominal pain will receive two sequential APB treatments (steroid injection followed by heat treatment) six month apart. Participants will be asked to complete questionnaires on pain scores, mood and quality of life. Length of hospital stay, number of hospital re-admission following APB treatment as well as any complication from the APB treatment will be recorded. Participation in the study will end at 12 months following the first APB treatment on completion of relevant questionnaires.

    Summary of Results
    The study evaluated 30 patients presenting with acute exacerbation of their longstanding abdominal pain. The aim was to observe if abdominal plane blocks with steroid medication provided any benefit in this cohort.

    Abdominal plane blocks were effective in providing pain relief, early discharge of patients from the hospital as well as prevent hospital readmission

  • REC name

    East Midlands - Leicester South Research Ethics Committee

  • REC reference

    18/EM/0419

  • Date of REC Opinion

    20 Dec 2018

  • REC opinion

    Further Information Favourable Opinion