scholarly journals Effect of Transversus Abdominis Plane Block on Postoperative Pain after Colorectal Surgery: A Meta-Analysis of Randomized Controlled Trials

2018 ◽  
Vol 27 (2) ◽  
pp. 158-165 ◽  
Author(s):  
Lin Liu ◽  
Yan-Hu Xie ◽  
Wei Zhang ◽  
Xiao-Qing Chai
Keyword(s):  
Postoperative Pain ◽  
Colorectal Surgery ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Analgesic Efficacy ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Randomized Controlled ◽  
Randomized Controlled Studies

Objectives: To assess the analgesic efficacy of transversus abdominis plane (TAP) block in patients undergoing colorectal surgery (CRS). Materials and Methods: The databases of PubMed, ISI Web of Science, and Embase were searched, and randomized controlled studies (RCTs) that compared TAP block to control for relief of postoperative pain in patients who underwent CRS were included. Outcomes, including postoperative pain at rest and with movement, morphine use, postoperative nausea and vomiting, and the length of hospital stay, were analyzed using STATA software. The weighted mean differences (WMDs) with 95% confidence intervals (95% CIs) or relative risk with 95% CI were used to present the strength of associations. Results: A total of 7 RCTs with 511 patients were included. The results of this study suggested that TAP block significantly relieved postoperative pain during postanesthetic recovery after CRS at rest and during movement (WMDs were –0.98 [95% CI –1.57 to –0.38] and –0.68 [–1.07 to –0.30], respectively), and also decreased pain intensity during movement 24 h after CRS (WMD: –0.57 [95% CI –1.06 to –0.08]). TAP block significantly reduced opioid consumption within 24 h when compared to controls, with a WMD of 15.66 (95% CI –23.93 to –7.39). However, TAP block did not shorten the length of hospital stay. Conclusions: TAP block was an effective approach for relief of postoperative pain and reduced postoperative consumption of morphine. More RCTs with large sample sizes are required to confirm these findings.

scholarly journals Transversus Abdominis Plane Block versus Wound Infiltration with Conventional Local Anesthetics in Adult Patients Underwent Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials

2020 ◽  
Vol 2020 ◽  
pp. 1-18 ◽  
Author(s):  
Qiang Cai ◽  
Mei-ling Gao ◽  
Guan-yu Chen ◽  
Ling-hui Pan
Keyword(s):  
Patient Satisfaction ◽  
Postoperative Pain ◽  
Local Anesthetics ◽  
Meta Analysis ◽  
Adult Patients ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Wound Infiltration ◽  
Randomized Controlled

Background. How to effectively control the postoperative pain of patients is extremely important to clinicians. Transversus abdominis plane (TAP) block is a novel analgesic method reported to greatly decrease postoperative pain. However, in many areas, there still exists a phenomenon of surgeons using wound infiltration (WI) with conventional local anesthetics (not liposome anesthetics) as the main means to decrease postoperative pain because of traditional wisdom or convenience. Here, we compared the analgesic effectiveness of the two different methods to determine which method is more suitable for adult patients. Materials and methods. A systematic review and meta-analysis of randomized controlled trials (RCTs) comparing TAP block and WI without liposome anesthetics in adult patients were performed. Frequently used databases were extensively searched. The main outcomes were postoperative pain scores in different situations (at rest or during movement) and the time until the first use of rescue analgesics. The secondary outcomes were postoperative nausea and vomiting (PONV) incidence and patient satisfaction scores. Results. Fifteen studies with 983 participants met the inclusion criteria and were included in the present study. The heterogeneity in the final analysis regarding the pain score was low to moderate. The major results of the sensitivity analysis were stable. WI had the same analgesic effect as TAP block only at the one-hour postoperative time point (mean difference=−0.32, 95% confidence interval (-0.87, 0.24), P=0.26) and was associated with a shorter time until the first rescue analgesic and poorer patient satisfaction. Conclusion. TAP block results in a more effective and steady analgesic effect than WI with conventional local anesthetics in adult patients from the early postoperative period and obtains higher patient satisfaction.

scholarly journals Analgesic efficacy of ultrasound-guided transversus abdominis plane block for laparoscopic gynecological surgery: a randomized controlled trial

2022 ◽  
Author(s):  
Divya Sethi ◽  
Garima Garg
Keyword(s):  
Postoperative Pain ◽  
Controlled Trial ◽  
Analgesic Efficacy ◽  
Port Site ◽  
Transversus Abdominis ◽  
Gynecological Surgery ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Significant Difference

Background: This study aimed to determine whether ultrasound-guided transversus abdominis plane (TAP) block is more effective in reducing postoperative pain and analgesic consumption than local anesthetic infiltration (LAI) at the port site for elective laparoscopic gynecological surgeries.Methods: Eighty patients with the American Society of Anesthesiologists status I/II undergoing laparoscopic gynecology surgery were enrolled for this randomized control trial. After general anesthesia was administered, patients in group C received LAI at each port site, and patients in group T received bilateral ultrasound-guided TAP. Postoperative pain was assessed at time intervals of 1/2, 2, 4, 6, 8, and 24 h using the numeric pain scale (NPS). Clinical metrics such as postoperative analgesic diclofenac consumption, need for rescue fentanyl, nausea-vomiting scores, and antiemetic requirements were also recorded.Results: Seventy-four patients were included in the final analysis. Postoperatively, patients in group T had significantly lower NPS than those in group C (P < 0.05). The highest difference in the postoperative NPS was observed at 2 h (median [1Q, 3Q]; group C = 3 [2, 4]; group T = 1 [0, 2]; P < 0.001). A statistically significant difference was observed in the frequency of diclofenac (75 mg intravenous) requirement between the groups (P = 0.010). No significant difference was observed between the groups in need of rescue fentanyl or antiemetic and the nausea-vomiting scores.Conclusions: In patients undergoing laparoscopic gynecological surgery, ultrasound-guided TAP block provided greater postoperative analgesic benefits in terms of lower NPS and reduced analgesic requirements than port site LAI.

scholarly journals The Analgesic Efficacy of Ultrasound-guided Transversus Abdominis Plane (TAP) Block Combined With Oral Multimodal Analgesia In Comparison With Oral Multimodal Analgesia After Caesarean Delivery: A Randomized Controlled Trial

2020 ◽  
Author(s):  
YANG YU ◽  
Shenshan GAO ◽  
Vivian Manying YUEN ◽  
Wai Siu CHOI ◽  
Xuebing XU
Keyword(s):  
Postoperative Pain ◽  
Caesarean Delivery ◽  
Breakthrough Pain ◽  
Controlled Trial ◽  
Multimodal Analgesia ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Randomized Controlled ◽  
Oral Analgesia

Abstract Background: The transversus abdominis plane (TAP) block is used increasing in parturients after caesarean delivery. This is a randomized controlled trial to evaluate the effectivenss of TAP in patients who received multimodal oral analgesia for postoperative pain relief.Methods: Parturient who were scheduled for elective caesarean delivery under spinal anaesthesia were recruited and randomized to receive TAP block or placebo in addition to multimodal oral analgesia which consisted of regular tramadol, celecoxib and paracetamol, with oral oxycodone used as rescue for breakthrough pain. Only parturient in TAP group would have an injection of local anaesthesia under aseptic techniques. All the parturient were evaluated for pain or related complications in the first 24 hours after surgery. Results: Eighty and 79 parturients were allocated to TAP and placebo group respectively. Nine out of 79 (11.4%) and 15 out of 73 (20.5%) parturients required oxycodone for breakthrough pain, P = 0.122. There was no difference in postoperative pain score and patient satisfactory score between the two groups. Conclusions: TAP block confers little additional benefit when multi-modal oral analgesic regimen is used for postoperative pain control after caesarean section under spinal anaesthesia.Trial registration:Clinical Trial Registry of China (http://www.chictr.org.cn, ChiCTR-INR-16010130). Retrospective registered on Dec 12, 2016

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