Transversus Abdominis Plane Block for Laparoscopic Hysterectomy Pain: A Meta-Analysis. Review uri icon

Overview

abstract

  • OBJECTIVE: Review the analgesic effect of the transversus abdominis plane (TAP) block and its impact on postoperative pain scores and opioid usage for patients undergoing laparoscopic and robotic hysterectomies. METHODS: Systematic review with meta-analysis of randomized controlled trials that compared the effect of TAP block to either placebo or no block on narcotic use (in morphine equivalent units [MEq]) and pain (per visual analog scale) within 24] h after a laparoscopic or robotic hysterectomy for benign or malignant indications. Searches were conducted in PubMed and Embase through May 31, 2019. RESULTS: Nine randomized controlled trials met eligibility criteria; 7 evaluated laparoscopic hysterectomy and 2 robotic hysterectomy. A total of 688 subjects were included (559 laparoscopic hysterectomy, 129 robotic hysterectomy). Opioid consumption was similar in the first 24] h postoperative with or without TAP block (-0.8 MEq; 95% CI, -2.9, 1.3; 8 TAP arms; N] = 395). Pain scores (visual analog scale) were also similar with or without TAP block (-0.01 U; 95% CI, -0.34, 0.32; 10 TAP arms; N] = 636). Neither meta-analysis showed statistical heterogeneity across studies. CONCLUSIONS: The evidence does not support a benefit of TAP block to reduce pain or opioid use for patients receiving laparoscopic or robotic hysterectomies.

publication date

  • January 1, 2020

Research

keywords

  • Abdominal Muscles
  • Hysterectomy
  • Laparoscopy
  • Nerve Block
  • Pain, Postoperative
  • Robotic Surgical Procedures

Identity

PubMed Central ID

  • PMC7234801

Scopus Document Identifier

  • 85086356249

Digital Object Identifier (DOI)

  • 10.4293/JSLS.2020.00018

PubMed ID

  • 32518477

Additional Document Info

volume

  • 24

issue

  • 2