Lidocaine Plasters as a Non-Invasive Alternative Treatment Option in Children With Anterior Cutaneous Nerve Entrapment Syndrome (Acnes)

Background Chronic abdominal pain in children can sometimes be attributed to Anterior Cutaneous Nerve Entrapment Syndrome (ACNES), a typical abdominal wall neuropathic pain entity. Not only the diagnosis but also the treatment poses various challenges. Usually, treatment starts with tender point injections, which are considered minimally invasive. Nevertheless, these injections can be quite burdensome for children, who might even refuse them. However, the alternative, surgical neurectomy, is far more invasive. The use of Lidocaine 5% medicated plasters, used successfully in various neuropathic pain conditions, might offer a non-invasive alternative for children with ACNES. This retrospective case series aims to evaluate the effectiveness and tolerability of lidocaine plasters in children with ACNES. Method Children under 18 diagnosed with ACNES, and treated with lidocaine medicated plasters from December 2021 to December 2022, were included. Treatment outcomes, including pain reduction and complications, were extracted from electronic patient records. Results Twelve of the sixteen children diagnosed with ACNES started the lidocaine plaster treatment. Mean age was 13 years (F:M ratio 3:1). The lidocaine plaster treatment resulted in lasting pain reduction in three patients, with two achieving a pain free status. Temporary pain reduction was noted in five patients. The last four patients experienced no pain relief during plaster treatment. One patient reported a skin rash, which disappeared a few days after not applying the plaster. Conclusion Lidocaine plasters might be considered as a non-invasive treatment option for children with ACNES, providing significant pain relief in a substantial portion of them.