Over the last few decades, advances have been made in the understanding of myofascial pain syndromes (MPSs). In spite of its high prevalence in the society, it is not a commonly established diagnosis. MPS is said to be the great imitator. This article puts some light on the various clinical presentations of the syndrome, on the various tools to reach to a diagnosis for commencing the treatment and on the treatment modalities that have been used so far.
Background: This study is intended to evaluate the transversus abdominis plane (TAP) block for analgesia over the first 24 postoperative hours after lower segment cesarean section. Materials and methods: Fifty female parturients of American society of Anesthesiologists (ASA) physical status II undergoing lower segment cesarean section were randomized to undergo a bilateral TAP block with ropivacaine (group 1 = 25) or to undergo a bilateral TAP block with 0.9% saline (group 2 = 25). In addition, all patients received standard analgesic injection tramadol 100 mg and im injection diclofenac 75 mg as required in the postoperative period. All patients received standard spinal anesthesia, and TAP block was performed at end of the surgery. Each patient was assessed after operation at each half an hours up to 24 hours after surgery in postoperative period. Results: The mean visual analog scale (VAS) score of group 1 was statistically less than mean VAS score of group 2 (p < 0.001). The mean of total number analgesic requirement for first 24 hours postoperatively was significantly less in group 1 (1.68 ± 0.9) than group 2 (2.8 ± 0.33) respectively. Conclusion: Transversus abdominis plane block holds considerable promise as part of a multimodal analgesic regimen for post cesarean delivery analgesia. Transversus abdominis plane block is easy to perform and provided reliable and effective analgesia.
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