Effects of preoperative ultrasound-guided transversus abdominis plane block on pain after laparoscopic surgery for colorectal cancer: a double-blind randomized controlled trial

Oh, Tak Kyu; Yim, Jiyeon; Kim, Jae Hyun; Eom, Woosik; Lee, Soon Ae; Park, Sung Chan; Oh, Jae Hwan; Park, Ji Won; Park, Boram; Kim, Dae Hyun

doi:10.1007/s00464-016-4941-7

Cited by 50 publications

(59 citation statements)

References 17 publications

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“…1; see www.karger.com/doi/10.1159/000487323 for all online suppl. material) [2,[9][10][11][12][13][14]. The characteristics of the included studies are shown in online supplementary Table 1.…”

Section: Description Of Included Trialsmentioning

confidence: 99%

“…Sample sizes ranged from 40 to 147 patients. Among the included studies, 5 reported that TAP block was performed after the induction of anesthesia [2,10,[12][13][14], and 2 studies reported that TAP block was conducted at the end of surgery [9,11]. In addition, ultrasound-guided TAP block was conducted in 5 trials, and conventional TAP block was performed in 2 [9,11].…”

Section: Description Of Included Trialsmentioning

confidence: 99%

“…A total of 5 [2,10,11,13,14] and 4 trials [2,10,13,14] were included for analysis of pain intensity during PAR at rest and during movement, respectively. Pain intensity was significantly decreased in patients receiving TAP block as compared to controls during PAR after surgery at rest and during movement (WMD rest : -1.10 [95% CI -1.43 to -0.76], p < 0.001; p heterogeneity = 0.082 and I 2 = 51.6%; WMD movement : -0.68 [95%CI -1.07 to -0.30], p < 0.001; p heterogeneity = 0.777 and I 2 = 0%) (Fig.…”

Section: Postoperative Pain Intensitymentioning

confidence: 99%

“…Several clinical trials have reported the effect of TAP block in patients who underwent CRS [2,[9][10][11][12][13][14]; however, the results of these studies were conflicting. A clinical study conducted by Tikuisis et al [2] on 64 patients undergoing elective colonic resection for cancer reported that TAP block was effective in reducing postoperative pain and shortening the length of hospital stay.…”

Section: Introductionmentioning

confidence: 99%

“…Another clinical trial by Torup et al [13] found that TAP block did not relieve postoperative pain but reduced opioid use after laparoscopic hemicolectomy. However, 2 clinical trials suggested that TAP block appeared to be a safe intervention but provided no specific advantage in CRS [12,14]. This meta-analysis was conducted in order to determine whether TAP block is an effective approach for the relief of postoperative pain.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2018

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Significance of the Study• The effect of transversus abdominis plane (TAP) block on postoperative pain remains uncertain. This meta-analysis aimed to assess the analgesic efficacy of TAP block in patients undergoing colorectal surgery (CRS). Based on 7 clinical trials, we found that TAP block reduced postoperative acute pain and morphine consumption. This study provides evidence for the application of TAP block in patients who undergo CRS.

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Section: Description Of Included Trialsmentioning

confidence: 99%

Section: Description Of Included Trialsmentioning

confidence: 99%

Section: Postoperative Pain Intensitymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

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

et al. 2018

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Network meta-analysis of local and regional analgesia following colorectal resection

Varghese

Bissett

et al. 2020

British Journal of Surgery

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Background Postoperative pain management after colorectal surgery remains challenging. Systemic opiates delivered on demand or via a patient‐controlled pump have traditionally been the mainstay of treatment. Opiate analgesia is associated with slower gastrointestinal recovery and unpleasant side‐effects; many regional and local analgesic techniques have been developed as alternatives. Methods MEDLINE, Embase and CENTRAL databases were searched systematically for RCTs comparing analgesic techniques after major colorectal resection. A network meta‐analysis was performed using a Bayesian random‐effects framework with a non‐informative prior. Primary outcomes included pain at rest and cumulative opiate consumption 24 h after surgery. Secondary outcomes included pain at rest and cumulative opiate consumption at 48 h, pain on movement and cough at 24 and 48 h, time to first stool, time to tolerance of oral diet, duration of hospital stay, nausea and vomiting, and postoperative complications. Results Seventy‐four RCTs, including 5101 patients and 11 different techniques, were included. Some inconsistency and heterogeneity was found. SUCRA scores showed that spinal analgesia was the best intervention for postoperative pain and opiate reduction at 24 h. Transversus abdominus plane blocks were effective in reducing pain and opiate consumption 24 h after surgery. Subgroup analysis showed similar results for open versus minimally invasive surgical approaches, and enhanced recovery after surgery programmes. Conclusion Spinal analgesia and transversus abdominus plane blocks best balanced pain control and opiate minimization in the immediate postoperative phase following colorectal resection. Multimodal analgesia reduces pain, minimizes systemic opiate use and optimizes postoperative recovery.

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Effects of modified multimodal analgesia on postoperative pain, sedation, and prognosis of gynecological patients

Zhang

Luo

Liu

et al. 2021

Ibrain

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Patient-controlled intravenous analgesia is one of the most common pain relief methods in the postoperative period, but its adverse reactions remain high.This study aimed to explore the role of improved combined analgesia methods in pain, sedation, postoperative nausea, and vomiting (PONV) in patients undergoing gynecological surgeries. This study was a prospective, randomized, double-blind controlled study. A study population of 72 patients undergoing gynecological surgery were randomly assigned to either the TAPB + S group or the TAPB + N group. All patients in both groups underwent a transversus abdominis plane block (TAPB) after induction of anesthesia. The TAPB + S group received a continuous intravenous infusion (2 ml/h) of sufentanil (1 μg/kg) plus metoclopramide (30 mg) through 100 ml elastomeric pumps postoperatively. The TAPB + N group received a continuous intravenous infusion (2 ml/h) of nalbuphine hydrochloride (1 mg/kg) plus metoclopramide (30 mg) postoperatively. The main outcome measures were as follows: postoperative pain intensity, Ramsay sedation score (RSS) after surgery, PONV occurrence rate, and rescue analgesics. The RSS of the TAPB + S group was significantly higher than that of the TAPB + N group at 2, 4, and 6 h after the operation. However, the visual analog scale score of the TAPB + S group was much higher than that of the TAPB + N group. No significant differences were found between the two groups in terms of consumption of opioids and other narcotic drugs at 2, 4, 6, 24, and 48 h after the operation. No statistically significant differences were found with respect to PONV and other adverse events in both groups. Taken together, our data indicate that the TAPB + N program can provide better postoperative analgesia and also reduce the use of strong opioids. The more optimized scheme of perioperative analgesia still needs to be researched further.

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Effects of preoperative ultrasound-guided transversus abdominis plane block on pain after laparoscopic surgery for colorectal cancer: a double-blind randomized controlled trial

Abstract: In colorectal cancer patients undergoing laparoscopic colorectal surgery, a TAP block did not offer enough benefit for clinical efficacy in terms of postoperative pain or analgesic consumption.

Cited by 50 publications

References 17 publications

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

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

Network meta-analysis of local and regional analgesia following colorectal resection

Effects of modified multimodal analgesia on postoperative pain, sedation, and prognosis of gynecological patients

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