Efficacy of ultrasound-guided transversus abdominis plane block in laparoscopic hysterectomy. Clinical trial

Guardabassi, D.S.; Lupi, S.; Agejas, R.; Allub, J.M.; García-Fornari, G.

doi:10.1016/j.redare.2016.12.003

Cited by 5 publications

(29 citation statements)

References 11 publications

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“…Ghisi and coworkers40 compared ultrasound-guided TAP block with systemic opioid analgesia and found no advantage in terms of VAS score, opioid consumption, postoperative mobilization, or adverse events. Finally, Guardabassi and colleagues41 found no advantage in terms of opioid consumption during the first 24 hours, and no difference in pain scores, when TAP blocks were added to a systemic analgesia regimen including opioid PCA.…”

Section: Resultsmentioning

confidence: 98%

Pain management after laparoscopic hysterectomy: systematic review of literature and PROSPECT recommendations

Lirk

Thiry

Bonnet

et al. 2019

Reg Anesth Pain Med

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Background and objectivesLaparoscopic hysterectomy is increasingly performed because it is associated with less postoperative pain and earlier recovery as compared with open abdominal hysterectomy. The aim of this systematic review was to evaluate the available literature regarding the management of pain after laparoscopic hysterectomy.Strategy and selection criteriaRandomized controlled trials evaluating postoperative pain after laparoscopic hysterectomy published between January 1996 and May 2018 were retrieved, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, from the EMBASE and MEDLINE databases and the Cochrane Register of Controlled Trials. Efficacy and adverse effects of analgesic techniques were assessed.ResultsOf the 281 studies initially identified, 56 were included. Of these, 31 assessed analgesic or anesthetic interventions and 25 assessed surgical interventions. Acetaminophen, non-steroidal anti-inflammatory drugs, and dexamethasone reduced opioid consumption. Limited evidence hindered recommendations on alpha-2-agonists. Inconsistent evidence was found in the studies investigating pregabalin and transversus abdominis plane block, and no evidence was found for intraperitoneal local anesthetics, port site infiltration, or single-port laparoscopy. Measures to lower peritoneal insufflation pressure or humidify or heat insufflated gas seem to reduce the incidence of shoulder pain, but not abdominal pain.ConclusionsThe baseline analgesic regimen for laparoscopic hysterectomy should include acetaminophen, a non-steroidal anti-inflammatory drug, dexamethasone, and opioids as rescue analgesics.

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Section: Resultsmentioning

confidence: 98%

Pain management after laparoscopic hysterectomy: systematic review of literature and PROSPECT recommendations

Lirk

Thiry

Bonnet

et al. 2019

Reg Anesth Pain Med

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show abstract

“…Hysterectomies were performed for benign indications in four studies, 17,19,21,25 for malignancy in one study, 23 for both indications in two studies, 20,24 and for unspecified reasons in two studies. 22,26 The studies compared TAP block to either placebo with saline or no block with the exception of one study described below. 24 Medications used for the blocks were 0.25% bupivacaine in three studies, 19,23,24 0.375% bupivacaine in one study, 25 0.375% levobupivacaine in one study, 22 0.5% ropivacaine in three studies, 20,21,26 and one study had 2 medication arms using 0.5% and 0.25% ropivacaine.…”

Section: Resultsmentioning

confidence: 99%

“…22,26 The studies compared TAP block to either placebo with saline or no block with the exception of one study described below. 24 Medications used for the blocks were 0.25% bupivacaine in three studies, 19,23,24 0.375% bupivacaine in one study, 25 0.375% levobupivacaine in one study, 22 0.5% ropivacaine in three studies, 20,21,26 and one study had 2 medication arms using 0.5% and 0.25% ropivacaine. 17 Four studies compared bilateral TAP injections with saline placebo blocks 17,19,20,25 and three other bilateral studies compared to no block.…”

Section: Resultsmentioning

confidence: 99%

“…17 Four studies compared bilateral TAP injections with saline placebo blocks 17,19,20,25 and three other bilateral studies compared to no block. 21,22,26 There were two unilateral block studies, one randomizing subjects to either a unilateral TAP block or placebo, 23 and one study comparing a unilateral TAP block to the contralateral site treated with port site infiltration of the same medication in divided doses. 24 Studies varied in the timing of the TAP block and technique of placement.…”

Section: Resultsmentioning

confidence: 99%

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Transversus Abdominis Plane Block for Laparoscopic Hysterectomy Pain: A Meta-Analysis

Shin

Balk

Gritsenko

et al. 2020

JSLS

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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 (Ϫ0.8 MEq; 95% CI, Ϫ2.9, 1.3; 8 TAP arms; N ϭ 395). Pain scores (visual analog scale) were also similar with or without TAP block (Ϫ0.01 U; 95% CI, Ϫ0.34, 0.32; 10 TAP arms; N ϭ 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.

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“…In a previous study, TAP blocks were found to have additional analgesic effects when used with intravenous tramadol-based PCA alone during the first 24 hours after surgery, and subcostal TAP block was associated with lower VAS scores than lateral TAP block in patients that underwent laparoscopic cholecystectomy [27]. However, Guardabassi et al [31] reported that a combination of TAP block and opioid-based PCA did not improve postoperative pain after laparoscopic hysterectomy. The present study also revealed that neither TAP block decreased postoperative pain when administered with intravenous fentanyl (20 μg/kg)…”

Section: Discussionmentioning

confidence: 97%

Comparison of analgesic efficacy of oblique subcostal and lateral transversus abdominis plane block after laparoscopic cholecystectomy

Jee

Jung

et al. 2018

Med Biol Sci Eng

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Efficacy of ultrasound-guided transversus abdominis plane block in laparoscopic hysterectomy. Clinical trial

Cited by 5 publications

References 11 publications

Pain management after laparoscopic hysterectomy: systematic review of literature and PROSPECT recommendations

Pain management after laparoscopic hysterectomy: systematic review of literature and PROSPECT recommendations

Transversus Abdominis Plane Block for Laparoscopic Hysterectomy Pain: A Meta-Analysis

Comparison of analgesic efficacy of oblique subcostal and lateral transversus abdominis plane block after laparoscopic cholecystectomy

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