Abdominal Cutaneous Nerve Entrapment (ACNES) Injection: Difference between revisions
From WikiMSK
Line 20: | Line 20: | ||
* Position: Supine | * Position: Supine | ||
* | * Ultrasound: Transverse plane, identify linea alba - the medial border of the rectus abdominis. Move laterally to find the linea semilunaris. | ||
* Advance needle lateral to medial, entering approximately 0.5โ1 cm medial to the hyperechoic semilunaris, reaching the abdominal cutaneous nerve exist. | * Advance needle lateral to medial, entering approximately 0.5โ1 cm medial to the hyperechoic semilunaris, reaching the abdominal cutaneous nerve exist. | ||
* Aspirate to ensure needle not penetrated a blood vessel. | * Aspirate to ensure needle not penetrated a blood vessel. |
Revision as of 17:50, 18 June 2020
Equipment
Syringe | Needle | Steroid | Local Anaesthetic | Total Volume |
10mL | 25G 38mm | optional 10mg triamcinolone | Clinician choice | 10mL |
Technique
- Position: Supine
- Ultrasound: Transverse plane, identify linea alba - the medial border of the rectus abdominis. Move laterally to find the linea semilunaris.
- Advance needle lateral to medial, entering approximately 0.5โ1 cm medial to the hyperechoic semilunaris, reaching the abdominal cutaneous nerve exist.
- Aspirate to ensure needle not penetrated a blood vessel.
- Inject local anaesthetic +/- steroid.
Indications
Anterior Cutaneous Nerve Entrapment Syndrome
Risks
Infection, subcutaneous injection, allergic reaction, intravascular injection ADR from steroids
Aftercare
Advised to keep active within pain limits, and is reassessed about 10 days later. Steroid remains in situ for about 2 weeks. Up to 3-4 injections may be performed before declaring the therapy a failure.