Levator ani trigger point injections: An underutilized treatment for chronic pelvic pain
Levator ani trigger point injections: An underutilized treatment for chronic pelvic pain
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DOI：
10.1002/nau.20393
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发表时间：
2007-01-01
影响因子：
2
通讯作者：
Ghoniem, Gamal M.
中科院分区：
文献类型：
--
作者：
Langford, Carolyn F.;Nagy, Szilvia Udvari;Ghoniem, Gamal M.
目的：我们进行这项研究是为了检查触发点注射对于患有至少 6 个月慢性盆腔疼痛 (CPP) 的女性以及特定提肛肌触发点的作用。方法：这项前瞻性研究包括 18 名连续患有 CPP 和特定可触及提肛肌触发点的女性患者。在触发点注射之前和之后通过视觉模拟量表（VAS）评估疼痛。患者总体满意度 (PGS) 和治愈率 (PGC) 也通过 VAS 以 0-100% 的范围进行测量。通过阴道内触诊双侧提肛肌手动识别触发点。使用 10 cc 0.25% 布比卡因、10 cc 2% 利多卡因和 1 cc (40 mg) 曲安西龙的混合物，每个触发点注射 5 cc。使用 5.5 英寸爱荷华州喇叭阴部针导向器进行注射。除一次注射外，所有注射均在办公室环境中进行，无需镇静。注射后进行骨盆底肌肉锻炼。成功的定义是通过 VAS 测量的疼痛减轻 50% 或更多，以及 PGS 和 PGC 评分 60% 或更高。触发点注射后平均随访时间为 3 个月。结果：18 名女性中有 13 名女性首次触发点注射的综合成功率达到 72%。 结论：在治疗 CPP 时，非手术治疗（例如触发点注射）对选定的患者有效。26:59-62, 2007 (c) 2006 Wiley-Liss, Inc.
Aims: We conducted this study to examine the role of trigger point injections in females with chronic pelvic pain (CPP) of at least 6 months duration and specific levator ani trigger points. Methods: This Prospective Study included 18 consecutive female patients with CPP and specific palpable levator ani trigger points. Pain was evaluated before and after trigger point injection on a Visual Analog Scale (VAS). Patient global satisfaction (PGS) and cure rates (PGC) were also measured by a VAS on a scale of 0-100%. The trigger points were identified manually by intravaginal palpation of the levator ani bilaterally. A mixture of 10 cc of 0.25% bupivacaine, 10 cc of 2% lidocaine and 1 cc (40 mg) of triamcinolone was used for injection of 5 cc per trigger point. A 5.5" Iowa trumpet pudendal needle guide Was used for injection. All but one injection were performed in the office setting without sedation. Pelvic floor muscle exercises were taught for use after injection. Success was defined as a decrease in pain as measured by a VAS of 50% or more, as well as PGS and PGC scores of 60% or greater. There was a mean follow tip of 3 months after trigger point injection. Results: Thirteen of 18 women improved with the first trigger point injection resulting in a comprehensive success rate of 72%. Six (33%) of 18 women were completely pain free. Conclusion: In the management: of CPP, a non-surgical office-based therapy such as trigger point injections can be effective in selected patients. Neurourol, Urodynam. 26:59-62, 2007 (c) 2006 Wiley-Liss, Inc.