Abdominal Plane Blocks (APB) in Chronic Abdominal Pain (CAP)
Abdominal Plane Blocks (APB) in Chronic Abdominal Pain (CAP)
Background: Chronic 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 chronic abdominal pain costs the economy in excess of £100 million per annum.
 The mechanism of CAP is poorly understood. Patients with acute exacerbation of their CAP 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. The investigators have shown that treating patients
 with steroid injection followed by pulsed radio frequency 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 is injected into a specific plane in the abdominal
 wall and is called abdominal plane block (APB). The investigators currently offer ABP
 treatment as a standard treatment in the management of patients with CAP.

 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 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 CAP will receive two
 sequential APB treatments (steroid injection followed by pulsed radio frequency treatment)
 six month apart. If the first treatment with steroid does not provide any benefit, the
 participants will receive a rescue treatment (trigger point injection with steroids).
 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.
Inclusion Criteria:

 1. All patients aged over 18 years.

 2. Chronic abdominal pain for above 6 months

 3. Moderate to severe pain in the abdomen: Baseline NRS >4 (worst pain the last 24 hours)

 Exclusion Criteria:

 1. Lack of consent, including from those patients who lack mental capacity to give
 informed consent.

 2. Patients with known history of drug allergy to depomedrone

 3. Patients with infection at injection site at on day of treatment.