Electromyographic characterisation of abdominal wall trigger points developed after caesarean section and response to local anaesthesia: an observational study. (15th April 2018)

• Record Type: Journal Article
• Authors: Poli‐Neto, OB; Campos Martins Chamochumbi, C; Toscano, P; Pitanguy Julio, M; Marques, W; Rosa‐e‐Silva, JC; Candido‐dos‐Reis, FJ; Nogueira, AA
• Is Part Of: BJOG. Volume 125:Number 10(2018)
• Page Start: 1313
• Page End: 1318
• Publication Date: 2018-04-15
• Subjects: Abdominal wall -- caesarean section -- chronic pelvic pain -- electromyography -- local anaesthesia -- myofascial pain -- neuralgia -- trigger points; Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1111/1471-0528.15204
• Languages: English
• ISSNs: 1470-0328

Abstract

Abstract : Objective: This study examines the electromyography pattern of abdominal trigger points developed after a caesarean section, and the association between clinical response and local anaesthetic injection. Design: Prospective cohort study. Setting: A tertiary university hospital. Population: Twenty‐nine women with chronic pelvic pain associated with trigger points after a caesarean section were included in the study. Methods: Participants received needle electromyography before treatment, then underwent a treatment protocol consisting of trigger‐point injection of 2 ml of 1% lidocaine. The protocol was repeated once a week for 4 weeks. The clinical responses of the patients were compared 1 week after and 3 months after treatment. The clinical trial is registered with the Brazilian Clinical Trials Registry (REBEC) under RBR‐42c6gz (www.ensaiosclinicos.gov.br/rg/RBR-42c6gz/ ). Main outcome measures: Needle electromyography and algometry results and pain reduction. Results: Fifteen patients had abnormal electromyography findings; 14 had normal findings. The rates of response 1 week and 3 months after treatment within the abnormal electromyography group were 95 and 87%, respectively. In the normal group, the rate was 38% both 1 week after and 3 months after treatment. Conclusions: Trigger points developed after caesarean section, even without clinical symptoms or signs of neuralgia, may originate from neuropathies. Electromyographic abnormalities were associated with pain remission after anaesthesia injection; normal electromyography findings were associated with undiagnosed causes of pain, such as adhesions. Tweetable abstract: Trigger points developed after caesarean section are neuropathies, even in the absence of classical neuralgia. Abstract : Tweetable abstract Trigger points developed after caesarean section are neuropathies, even in the absence of classical neuralgia.