Postoperative analgesic efficacy of modified continuous transversus abdominis plane block in laparoscopic colorectal surgery: a triple-blind randomized controlled trial

Haruethaivijitchock, P; Ng, Ju-Mei; Taksavanitcha, G; Theerawatanawong, J; Rattananupong, Thanapoom; Lohsoonthorn, Vitool; Sahakitrungruang, Chucheep

doi:10.1007/s10151-020-02311-9

Cited by 6 publications

(8 citation statements)

References 31 publications

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“…Three studies in our meta-analysis ( 22 , 26 , 27 ) reported the total morphine consumption in mg, and one ( 20 ) in fentanyl in mcg delivered via PCA which we converted into morphine consumption in mg. Walter et al ( 26 ) reported data for open surgery and laparoscopic colorectal surgery. They also reported the postoperative opioid consumption separately for laparoscopic colorectal surgery (LCS), so we used that data to keep consistency with other studies.…”

Section: Resultsmentioning

confidence: 99%

“…The value of I 2 is equal to 23%, the model shows heterogeneity, so we performed the sensitivity analysis by excluding one study at a time. The model is sensitive to the results of two studies ( 20 , 26 ), in which case the model is indifferent between TAP block and no block.…”

Section: Resultsmentioning

confidence: 99%

“…Due to the high heterogeneity of the studies, we performed the sensitivity analysis by excluding one study at a time. The model is sensitive to the results of a study by Haruethaivijitchock et al ( 20 ).…”

Section: Resultsmentioning

confidence: 99%

“…Only three studies reported the overall postoperative opioid consumption, but one of them ( 20 ) did not provide complete data values, so we were unable to include them in this analysis. Smith et al ( 24 ) reported data in terms of the sample mean and SEM, so we estimated the sample SD as SEM * SQRT( n ), where n is the sample size.…”

Section: Resultsmentioning

confidence: 99%

“…The pain intensity measured in NRS/VAS scores at rest recorded 24 h after laparoscopic surgery is presented in the forest plot (Figure 5). The model includes four studies (20,21,23,25). In this model, we used the standardized mean difference as Table 2 shows the distribution of types of colorectal surgery in RCTs in our meta-analysis.…”

Section: Pain Intensity In Nrs/vas Scores At Rest Recorded 24 H After...mentioning

confidence: 99%

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Transversus Abdominis Plane Block in Colorectal Surgery: A Meta-Analysis

2022

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Acute postoperative pain is one of the most common concerns during the early postoperative period in colorectal surgery. Opioids still represent the cornerstone of postoperative pain management, yet they often result in significant side effects such as nausea and/or vomiting, sedation, urinary retention, delayed recovery of colonic motility, respiratory depression, and postoperative ileus. Transversus abdominis plane (TAP) block has been widely used for postoperative analgesia in various abdominal surgeries. The primary aim of this meta-analysis was to compare the postoperative opioid requirements of patients in the TAP block group and the control group (placebo). The secondary aims included evaluation of the efficacy of TAP blocks in postoperative pain management, the measurement of time to first request for opioids, the measurement of length of hospital stay (LoS), and the documentation of postoperative nausea and/or vomiting. We searched for articles reporting the results of randomized controlled trials (RCTs) on the application of TAP block in colorectal surgery published before September 2021. Eight RCTs involving 615 patients were included in the meta-analysis. Seven articles reported the results of TAP blocks in laparoscopic surgery and eight in both laparoscopic and open surgery. The need for opioids and the intensity of pain at rest within 24 h after laparoscopic and combined (laparoscopic and open) surgeries were significantly lower in the TAP block group compared with the “no block” group. The intensity of pain during coughing within 24 hours after laparoscopic surgery was significantly lower in the TAP block groups compared to the groups without block. There were no statistically significant differences between the TAP block and “no block” groups in overall (over the entire hospital stay) postoperative opioid consumption and length of hospital stay after laparoscopic surgery, as well as in postoperative nausea and vomiting after laparoscopic and combined surgeries.

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