Limitations
In future research, we will not use prose for participant responses
regarding pain duration. We recommend using only multiple choice lists.
The questionnaire we sourced for nine out of our ten history features of
abdominal wall neuropathy was not generated for this purpose. It was
written to help delineate between Irritable Bowel Syndrome and ACNES
(9). It also does not describe the symptoms in terms of their
specificity for ACNES, but rather the percentage of patients with ACNES
using these descriptors.
There are other pain processes which pregnant people encounter which may
have skewed our responses. Participants may have responded positively
with descriptions of their pelvic girdle pain, symphysis pubis
disfunction and uterine contractions. For this reason, any future
studies on the subject should involve a Delphi method for questionnaire
development and clinician-guided participant interviews.
Of clinical note, dysesthesia and allodynia are also features of central
sensitisation, a complex pain syndrome involving amplification of pain
by central nervous system mechanisms (21). It is advisable to ask
patients if they suffer from chronic abdominal pain outside of
pregnancy. The impact of central sensitisation on the therapeutic effect
of a TAP block is as yet unknown.