Utilization of Truncal Fascial Plane Nerve Blocks for Chronic Pain Management: A Narrative Review

Abstract

Purpose of review: Nerve blocks constitute an integral portion in the management of chronic pain. The widespread use of ultrasound imaging opened the door to a flood of newer blocks especially truncal plane nerve blocks. We reviewed the current medical literature for studies and case reports utilizing the two most common truncal plane nerve blocks, transversus abdominis plane and erector spinae plane blocks, to manage chronic pain.

Recent findings: We found some evidence, mostly in case reports and retrospective observational studies, that supports the use of transversus abdominis plane and erector spinae plane nerve blocks, usually with steroids, as a safe and valuable part of interdisciplinary management of chronic abdominal and chest walls pain. Ultrasound-guided truncal fascial plane nerve blocks are safe, easy to learn, and proven to help with post-operative acute pain management. Although limited, our current review provides evidence from the current medical literature regarding the utility of these blocks to manage some of the challenging chronic and cancer-related pain conditions of the trunk region.

Keywords: Anterior cutaneous nerve entrapment syndrome; ESP; Erector spinae plane; Post-thoracotomy pain syndrome; Postherpetic neuralgia; TAP; Thoracic neuropathic pain; Transversus abdominis plane.