Subcostal Transversus Abdominis Plane (STAP) Block with Depot Steroids in the Management of Upper Abdominal Myofascial Pain Syndrome (AMPS)
Journal Title: Journal of Anesthesia and Surgery - Year 2017, Vol 4, Issue 2
Abstract
Background: Abdominal myofascial pain syndrome is a poorly recognised cause of chronic abdominal wall pain. Diagnosis is confirmed by a positive response to trigger point injection. In the presence of extensive myofascial pain, trigger point treatment can result in patient discomfort and distress. Recently, posterior transversus abdominis plane blocks have been reported in the diagnosis and treatment of chronic abdominal wall pain. Subcostal transversus abdominis plane block is an abdominal wall block that is effective for pain arising from the upper abdomen. The report describes the role of the ultrasound guided subcostal transversus abdominis plane block in the management of abdominal myofascial pain syndrome. Methods: Adult patients with myofascial pain syndrome localised in the upper abdomen under the care of a single physician at a tertiary pain medicine unit were offered bilateral ultrasound guided subcostal transversus abdominis plane block with a mixture of local anaesthetic and depot methylprednisolone instead of multiple trigger point injections as a part of an on-going prospective longitudinal audit into the management of abdominal myofascial pain syndrome. Patients completed brief pain inventory questionnaire at baseline and at 12 weeks post procedure. Results: Twenty patients underwent bilateral subcostal transversus abdominis plane blocks with depot steroids. All patients reported complete absence of pain within 15 minutes of the block. Clinically significant benefit at 12 weeks was reported by 60 % (12/20) of patients. Conclusion: Subcostal transversus abdominis plane block with depot steroids could play a role in the management of myofascial pain of the upper abdomen.
Authors and Affiliations
G Niraj
Keywords
Related Articles
- EP ID EP421199
- DOI 10.15436/2377-1364.17.093
- Views 90
- Downloads 0
Perioperative Pregabalin for Postoperative Pain Relief after Thoracotomy
Background: Pregabalin is effective both at controlling postoperative pain and preventing chronic neuropathic pain. Local anaesthetic infiltration is a simple and inexpensive method to provide postoperative analgesia. In...
The Efficacy of Three Different Doses of Intrathecal Fentanyl for Prevention of Shivering in Lower Limb Orthopedic Surgeries: A Randomized Double-Blind Controlled Trial
Background: Fentanyl has been used to prevent shivering in spinal anesthesia but still the effects of different doses have not been appropriately specified. The aim of this study was to assess the effect of 10 μg, 20 μg...
Ultrasound Guided Popliteal Nerve Block for Operative Ankle Instability Procedures
At our institution, OrthoIndy Hospital, prior to regional anesthesia, patients undergoing operative ankle instability procedures required overnight admissions to the hospital for pain control. Techniques of regional anes...
Intracranial Multiple Sites Recurrence and Extracranial Multiple Organs Metastasis of Intracranial Hemangiopericytoma
Purpose: As a rare and vascularized tumor, Intracranial hemangiopericytoma (HPC) has the significant clinical characters of local recurrence and distant metastasis including intracranial and extracrainal. The treatment o...
Minimizing Stress Response and Cognitive Dysfunction in Orthopedic Surgery: The Prospects of Epidural Anesthesia
Purpose: To evaluate the effect of epidural anesthesia on immune and inflammatory changes, and to indicate their possible correlation with cognitive functions in patients undergoing orthopedic surgery. Methods: Fifty-six...