1324 - Peripheral Nerve Stimulation to the Transverse Abdominis Plane as Therapy for Refractory Abdominal Pain: A Case Series

Friday, February 20, 2026

5:00 PM - 6:30 PM AST

Presenting Author(s)

PR

Preston Rippe, DO

Resident Physician
University of Kentucky
Lexington, Kentucky, United States

Co-Author(s)

MB

Madhur Batra, MD

Pain Medicine Physician
Spaulding Rehabilitation
Lexington, Kentucky, United States
MH

Michael Harned, MD

Interventional Pain Medical Director
University of Kentucky
Lexington, Kentucky, United States
CM

Christopher Mallard, MD

Interventional Pain Fellowship Program Director
University of Kentucky
Lexington, Kentucky, United States

Submitter(s)

PR

Preston Rippe, DO

University of Kentucky
Lexington, Kentucky, United States

Case Diagnosis: chronic abdominal pain secondary to ilioinguinal neuralgia and post-herpetic neuralgia

Case Description: Two patients with refractory abdominal pain received transverse abdominis plane peripheral nerve stimulation. Both patients had >90% reduction in their pain for the duration of the stimulation trial (60 days) and at their three-month follow up visit, with one patient having significant lasting pain relief for >5 months.

Discussions: PNS has been an established treatment for pain since as early as the 1960s and had increased popularity in the 1990s, following updated lead insertion techniques, leading to more utilization. TAP blocks were first described as a means for peri-/post-operative pain management however there is limited evidence for PNS to TAP for refractory abdominal pain. Current ASPN Best Practices Guidelines for PNS demonstrate 6 trunk/pelvic peripheral nerves appropriate for PNS, including the ilioinguinal and iliohypogastric nerves however as of 2022, it is still rated as Level III, Grade C of pain alleviation for neuropathic pain syndrome involving the trunk and back pain due to limited data. As chronic refractory abdominal pain can be severely limiting with both pain and function, and sometimes is difficult to treat considering the many various possible etiologies, peripheral nerve stimulation to the transverse abdominis plane is a viable treatment option for long-term relief.

Conclusions: Despite the limited evidence available for TAP PNS, clinical data suggests that PNS is a valuable and successful tool for improving chronic refractory abdominal pain. Further studies would be valuable in determining efficacy, safety, localization, and utility of PNS for refractory abdominal pain.