Ipsilateral Transversus Abdominis Plane Block Provides Effective Analgesia After Appendectomy in Children

Carney, John; Finnerty, Olivia; Rauf, Jassim; Curley, Gerard F.; McDonnell, John G.; Laffey, John G.

doi:10.1213/ane.0b013e3181ee7bba

Cited by 132 publications

(129 citation statements)

References 16 publications

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“…6). Compared with the control group, the TAP block reduced the 24-hr pain score 20,30,31,39,48,62 by 1.7 (95% CI, App/IS = appendectomy /inguinal surgery; CD = Cesarean delivery; CI = confidence interval; I 2 = heterogeneity; IAW = inside abdominal wall; TAP = transversus abdominal plane block; US = ultrasound -2.4 to -1.0; P \ 0.001) and 24-hr morphine consumption 30,39,62 by 20.4 mg (95% CI, -29.7 to -11.1; P \ 0.001) ( Table 2).…”

Section: Transversus Abdominal Plane Block In Appendectomy and Inguinmentioning

confidence: 83%

“…In inguinal hernia surgery and appendectomy, compared with the control group, the overall analysis showed that the TAP block reduced the six-hour pain score 20,30,31,39 by 2.5 (95% CI, -4.7 to -1.2; P = 0.001) and the 12-hr pain score 20,30,31,39,48 by 3.9 (95% CI, -5.0 to -2.9; P\0.001) (Fig. 6).…”

Section: Transversus Abdominal Plane Block In Appendectomy and Inguinmentioning

confidence: 97%

“…Pain scores at six and 12 hr were investigated in 23 and 18 [16][17][18][19][20][21][22][23]25,26,29,31,32,[34][35][36][38][39][40][41] studies, respectively. The overall analyses showed that, in the TAP block group, the six-hour VAS pain score was reduced by 1.4 (95% CI, -1.9 to -0.8; P \ 0.001) (Fig.…”

Section: Transversus Abdominal Plane Block Vs Placebomentioning

confidence: 99%

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Transversus abdominal plane block for postoperative analgesia: a systematic review and meta-analysis of randomized-controlled trials

Brogi

Kazan

Cyr

et al. 2016

Can J Anesth/J Can Anesth

133

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Purpose The transversus abdominal plane (TAP) block has been described as an effective pain control technique after abdominal surgery. We performed a systematic review and meta-analysis of randomized-controlled trials (RCTs) to account for the increasing number of TAP block studies appearing in the literature. The primary outcome we examined was the effect of TAP block on the postoperative pain score at six, 12, and 24 hr. The secondary outcome was 24-hr morphine consumption. Source We searched the United States National Library of Medicine database, the Excerpta Medica database, and the Cochrane Central Register of Controlled Clinical Studies and identified RCTs focusing on the analgesic efficacy of TAP block compared with a control group [i.e., placebo, epidural analgesia, intrathecal morphine (ITM), and ilioinguinal nerve block after abdominal surgery]. Meta-analyses were performed on postoperative pain scores at rest at six, 12, and 24 hr (visual analogue scale, 0-10) and on 24-hr opioid consumption. Principal findings In the 51 trials identified, compared with placebo, TAP block reduced the VAS for pain at six hours by 1.4 (95% confidence interval [CI], -1.9 to -0.8; P\0.001), at 12 hr by 2.0 (95% CI, -2.7 to -1.4; P\0.001), and at 24 hr by 1.2 (95% CI, -1.6 to -0.8; P \ 0.001). Similarly, compared with placebo, TAP block reduced morphine consumption at 24 hr after surgery (mean difference, -14.7 mg; 95% CI, -18.4 to -11.0; P \0.001). We observed this reduction in pain scores and morphine consumption in the TAP block group after gynecological surgery, appendectomy, inguinal surgery, bariatric surgery, and urological surgery. Nevertheless, separate analysis of the studies comparing ITM with TAP block revealed that ITM seemed to have a greater analgesic efficacy. Conclusions The TAP block can play an important role in the management of pain after abdominal surgery by reducing both pain scores and 24-hr morphine consumption. It may have particular utility when neuraxial techniques or opioids are contraindicated. RésuméObjectif Le bloc dans le plan du muscle transverse de l'abdomen (ou TAP bloc) a été décrit comme une technique efficace de contrô le de la douleur après une chirurgie abdominale. Nous avons réalisé une revue systématique et une méta-analyse des études randomisées contrô lées (ERC) pour faire un état des lieux du nombre croissant d'études

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Section: Transversus Abdominal Plane Block In Appendectomy and Inguinmentioning

confidence: 83%

Section: Transversus Abdominal Plane Block In Appendectomy and Inguinmentioning

confidence: 97%

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Transversus abdominal plane block for postoperative analgesia: a systematic review and meta-analysis of randomized-controlled trials

Brogi

Kazan

Cyr

et al. 2016

Can J Anesth/J Can Anesth

133

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“…Figure 1 showed the flow diagram for the study identification and selection process. After reading and evaluating the titles, abstracts and full texts, 5 studies with 257 children ultimately met our inclusion criteria (21)(22)(23)(24)(25). The characteristics and outcomes of each included studies were summarized in table.…”

Section: Search Resultsmentioning

confidence: 99%

Transversus Abdominis Plane Block to Alleviate Postoperative Pain in Children: A Meta-Analysis of Randomized Controlled Trials

Li¹,

Li²,

Xing³

et al. 2015

J Anesth Perioper Med

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Background: Transversus abdominis plane (TAP) block has been applied as one of multimodal approaches to alleviate postoperative pain in children. The aim of this meta-analysis was to determine the effect of TAP block on postoperative pain management for children who underwent surgery. Methods: The randomized controlled trials (RCTs) which evaluated the analgesia effect of TAP block in children who underwent surgery were searched on the databases of Medline, Embase, the Cochrane Controlled Trials Register and Google Scholar. The RCTs which compared the analgesic effect of TAP block group with control group (placebo or "no treatment") in children were included. Postoperative opioid consumption (48 hours) was considered as the primary outcomes. The secondary outcomes included the number of children needed postoperative opioid analgesia rescue, the time to first analgesic administration (hours) and pain score. The risk ratios (RR), weighted mean differences (WMDs), and their corresponding 95% con fi dence intervals (95% CIs) were calculated for both dichotomous and continuous outcomes. Results: Five RCT trials with 257 children met our criteria and were included in the analysis. Compared with the control group, TAP block reduced the 48 hours morphine consumption by 0.03 mg/kg (95% CI -0.05 to -0.00, P=0.03, 159 children in 3 RCTs). Besides, the non-signi fi cant reductions were shown in the number of children needed postoperative opioid analgesia rescue (217 children in 4 RCTs) and time to first analgesic administration (hours, 184 children in 3 RCTs). Conclusions: TAP block is one of the safe and effective multimodal-approaches to alleviate postoperative pain in children. Specially, when the TAP block was used, it can significantly reduce the opioid consumption, which may avoid the occurrence of dose-dependent side effects of opioid drugs.

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“…However, a number of studies showed a comparable efficacy of the blindly performed TAP block to ultrasound guided ones after abdominal surgery for variety of surgical cases if done appropriately [7,13]. Factors determining the efficacy of the block can either be the result of technical trouble in performing, surgical and patient factors [14,15].…”

Section: Introductionmentioning

confidence: 99%

Trans Abdominis Plan Block Reduce Postoperative Analgesic Requirement and Prolong Time to First Analgesic Request in Abdominal Surgery at University of Gondar Hospital: Prospective Observational Study

2015

JACCOA

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Background: Poorly controlled pain after abdominal surgery is associated with patient suffering and prolonged hospital stay. The increasing use of Transverse abdominis plan block (TAP), as a form of pain relief after abdominal surgery warrants evaluation of its effectiveness as an adjunctive technique to routine care and, when compared with other analgesic techniques. This observational study evaluated the efficacy of blindly performed TAP block after abdominal surgeries.

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Ipsilateral Transversus Abdominis Plane Block Provides Effective Analgesia After Appendectomy in Children

Abstract: Unilateral TAP block, as a component of a multimodal analgesic regimen, provided superior analgesia compared with placebo in the first 48 postoperative hours after appendectomy in children.

Cited by 132 publications

References 16 publications

Transversus abdominal plane block for postoperative analgesia: a systematic review and meta-analysis of randomized-controlled trials

Transversus abdominal plane block for postoperative analgesia: a systematic review and meta-analysis of randomized-controlled trials

Transversus Abdominis Plane Block to Alleviate Postoperative Pain in Children: A Meta-Analysis of Randomized Controlled Trials

Trans Abdominis Plan Block Reduce Postoperative Analgesic Requirement and Prolong Time to First Analgesic Request in Abdominal Surgery at University of Gondar Hospital: Prospective Observational Study

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