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Int J Clin Exp Med. 2014 Sep 15;7(9):2966-75. eCollection 2014.

Transversus abdominis plane block for postoperative analgesia after laparoscopic surgery: a systematic review and meta-analysis.

Author information

1
Department of Anesthesiology, Shanghai East Hospital, Tongji University School of Medicine Shanghai, China.
2
Department of Anesthesiology, Shanghai East Hospital, Tongji University School of Medicine Shanghai, China ; Department of First Clinical Medical College, Nanjing Medical University Nanjing, Jiangsu, China.

Abstract

BACKGROUND:

The increasing use of the transversus abdominis plane (TAP) block, as a form of pain relief after laparoscopic surgery, warrants evaluation of its effectiveness, when compared with other analgesic techniques.

METHODS:

We searched online databases of MEDLINE, EMBASE, Google scholar and The Cochrane Database of Systematic Review. Mean differences (MD) were formulated for continuous data; odds ratios (OR) were calculated for dichotomous data. Results were produced with a random effects model with 95% confidence intervals (CI).

RESULTS:

14 trials with a total of 905 patients were included for the analysis, TAP block resulted in significantly less postoperative analgesic consumption at 24 h (MD = -25.46, 95% CI [-32.22, -18.69], P < 0.00001), and less number of patients requiring analgesic postoperatively (OR = 0.16, 95% CI 0.03-0.87, P = 0.03). Meanwhile, pain sores were significantly different at 2 h (MD = -1.55, 95% CI [-2.50, -0.59], P < 0.00001), a borderline difference between the groups seen at 6 hours ( MD = -1.13, 95% CI [-1.69, -0.56], P = 0.05), and there was not affect pain at 24 h (MD = -0.33, 95% CI [-0.08, 0.15], P = 0.14) with TAP block groups compared with the groups without TAP block. There was a significant difference in postoperative nausea and vomiting (random effects model: OR = 2.04, 95% CI [1.19-3.48], P = 0.34).

CONCLUSION:

TAP block would result in less analgesic consumption, less requirement of analgesic, and less pain at 2 h and slightly at 6 h but at 24 h after laparoscopic surgery in comparison with usual care alone or placebo block. In addition TAP block can increase the incidence of postoperative nausea and vomiting.

KEYWORDS:

TAP block; laparoscopic surgery; meta-analysis; transversus abdominis plane block

PMID:
25356170
PMCID:
PMC4211820

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