Impact of Ultrasound-Guided Transversus Abdominis Plane Block on Postoperative Pain and Early Outcome After Laparoscopic Bariatric Surgery: a Randomized Double-Blinded Controlled Trial

Emile, Sameh Hany; Abdel-Razik, Mohamed Anwar; Elbahrawy, Khaled; Elshobaky, Ayman; Shalaby, Mostafa; Elbaz, Samy Abbas; Gado, Waleed; Elbanna, Hosam Ghazy

doi:10.1007/s11695-019-03720-y

Cited by 33 publications

(23 citation statements)

References 29 publications

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“…Emile and coworkers applied the Apfel score for postoperative nausea and vomiting: they also found a significant improvement with USG-TAP block for this outcome (2.1 ± 0.9 points in the USG-TAP group vs 3.0 ± 0.9 points, p < 0.001 in the control group) [35]. Mittal and coworkers reported a pooled number of events of nausea and/or vomiting and found 8/30 and 24/30 cases in the USG-TAP and control groups, respectively [36].…”

Section: Secondary Endpointsmentioning

confidence: 96%

“…Time to Postoperative Bowel Recovery One trial with 46 patients in each arm reported recovery of bowel functions assessed by time to first flatus, and they found a statistically significant difference favoring the USG-TAP block group (9.5 ± 1.9 vs 10.5 ± 2.2 h; p < 0.001) [35]. Mittal and coworkers also found earlier resumption of bowel activity in the intervention group [36].…”

Section: Secondary Endpointsmentioning

confidence: 99%

“…From the eight studies, five used sham-control (normal saline infiltration) [30][31][32][33][34]. In three studies, the control group did not receive sham-control [35][36][37]. One study used port-site infiltration in both intervention and control groups [37].…”

Section: Characteristics Of the Studies Includedmentioning

confidence: 99%

“…Two studies recruited patients who underwent laparoscopic gastric bypass surgery [34,37]. One trial studied patients with gastric band surgery [30] and one with several different types of laparoscopic bariatric surgery [35].…”

Section: Characteristics Of the Studies Includedmentioning

confidence: 99%

“…The type and dose of local anesthetic agents and those of USG-TAP approaches were different among studies. In four of the studies, USG-TAP block was performed immediately after completion of surgery [30][31][32]37]; the remaining studies carried out surgeries with preoperative USG-TAP block after anesthesia induction [33][34][35][36].…”

Section: Characteristics Of the Studies Includedmentioning

confidence: 99%

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Transversus Abdominis Plane Block Appears to Be Effective and Safe as a Part of Multimodal Analgesia in Bariatric Surgery: a Meta-analysis and Systematic Review of Randomized Controlled Trials

et al. 2020

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Purpose Pain after bariatric surgery can prolong recovery. This patient group is highly susceptible to opioid-related side effects. Enhanced Recovery After Surgery guidelines strongly recommend the administration of multimodal medications to reduce narcotic consumption. However, the role of ultrasound-guided transversus abdominis plane (USG-TAP) block in multimodal analgesia of weight loss surgeries remains controversial. Materials and Methods A systematic search was performed in four databases for studies published up to September 2019. We considered randomized controlled trials that assessed the efficacy of perioperative USG-TAP block as a part of multimodal analgesia in patients with laparoscopic bariatric surgery. Results Eight studies (525 patients) were included in the meta-analysis. Pooled analysis showed lower pain scores with USG-TAP block at every evaluated time point and lower opioid requirement in the USG-TAP block group (weighted mean difference (WMD) = − 7.59 mg; 95% CI − 9.86, − 5.39; p < 0.001). Time to ambulate was shorter with USG-TAP block (WMD = − 2.22 h; 95% CI − 3.89, − 0.56; p = 0.009). This intervention also seemed to be safe: only three non-severe complications with USG-TAP block were reported in the included studies. Conclusion Our results may support the incorporation of USG-TAP block into multimodal analgesia regimens of ERAS protocols for bariatric surgery.

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Section: Secondary Endpointsmentioning

confidence: 96%

Section: Secondary Endpointsmentioning

confidence: 99%