Management of chronic postoperative surgical pain (CPSP) following appendicectomy

A 35-year-old female presented with severe pain at the appendicectomy scar site of six months duration. She had an open appendicectomy done followed by continuous pain from the time of discharge. She was diagnosed as a case of chronic post surgical pain syndrome (CPSP). We administered transversus abdominis plane block (TAP) by ultrasound guidance depositing bupivacaine 0.25% 20ml and intralesional 80mg methylprednisolone as a depot preparation. The visual analogue score showed significant improvement from 7/10 to 1/10 for the next five months of follow up. We conclude that USG guided TAP block combined with intralesional steroid is a viable treatment option in cases of CPSP.