Transversus abdominis plane block using a short-acting local anesthetic for postoperative pain after laparoscopic colorectal surgery: a systematic review and meta-analysis

Oh, Tak Kyu; Lee, Se Jun; Hwan, Sang; Song, In Ae

doi:10.1007/s00464-017-5871-8

Cited by 29 publications

(20 citation statements)

References 39 publications

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“…There were several reasons for the difference in results between the study of Oh et al [26] and ours. First, our study focused on the impact of TAP block on postoperative pain after CRS (both open and laparoscopic surgery).…”

Section: Discussioncontrasting

confidence: 67%

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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: Discussioncontrasting

confidence: 67%

“…A recent meta-analysis to assess the impact of TAP block on laparoscopic CRS showed that TAP block reduced postoperative pain during PAR with movement and did not reduce postoperative pain 24 h after CRS and opioid consumption [26]. There were several reasons for the difference in results between the study of Oh et al [26] and ours.…”

Section: Discussionmentioning

confidence: 65%

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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“…Many factors can influence the postoperative pain after laparoscopic colorectal resection, such as abdominal incisions, pneumoperitoneum, operative dissection, and secondary peritonitis and ileus. [26,27] Previous studies have found that cold-dry CO 2 insufflation could desiccate the peritoneum, damage the peritoneal surface, induce inflammatory response, and then release various hyperalgesic substances such as kinins and prostaglandins. [28,29] Other studies found that prolonged cold-dry CO 2 insufflation during laparoscopic colorectal surgery could also result in serious peritoneal injury, which may increase the risk of peritoneal metastasis and port site metastasis.…”

Section: Discussionmentioning

confidence: 99%

Effect of different carbon dioxide (CO2) insufflation for laparoscopic colorectal surgery in elderly patients

et al. 2019

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Background:Evidence suggests that dry CO2 insufflation during laparoscopic colorectal surgery results in greater structural injury to the peritoneum and longer hospital stay than the use of warm, humidified CO2. We aimed to test the hypothesis that warm, humidified CO2 insufflation could reduce postoperative pain and improve recovery in laparoscopic colorectal surgery.Methods:One hundred fifty elderly patients undergoing laparoscopic colorectal surgery under general anesthesia from May 2017 to October 2018 were randomly divided into 3 groups. The primary outcomes were resting pain, cough pain, and consumption of sufentanil at 2, 4, 6, 12, 24, and 48 hours postoperatively. Quality of visual image, hemodynamic changes, esophageal temperature, mean skin temperature, mean body temperature, recovery time, days to first flatus and solid food intake, shivering, incidence of postoperative ileus, length of hospital stay, surgical site infections, patients and surgeon satisfaction scores, adverse events, prothrombin time, activated partial thromboplastin time, and thrombin time were recorded.Results:Group CE patients were associated with significantly higher early postoperative cough pain and sufentanil consumption than the other 2 groups (P < .05). Compared with group CE, patients in both groups WH and CF had significantly reduced intraoperative hypothermia, recovery time of PACU, days to first flatus and solid food intake, and length of hospital stay, while the satisfaction scores of both patients and surgeon were significantly higher (P < .05). Prothrombin time, activated partial thromboplastin time, and thrombin time were significantly higher in group CE from 60 minutes after pneumoperitoneum to the end of pneumoperitoneum than the other 2 groups (P < .05). The number of patients with a shivering grade of 0 was significantly lower and grade of 3 was significantly higher in group CE than in the other 2 groups (P < .05).Conclusion:Use of either warm, humidified CO2 insufflations or 20°C, 0% relative humidity CO2 combined with forced-air warmer set to 38°C during insufflations can both reduce intraoperative hypothermia, dysfunction of coagulation, early postoperative cough pain, sufentanil consumption, days to first flatus, solid food intake, and length of hospital stay.

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“…In 2018, Oh et al 184 restricted the scope of their review article to laparoscopic colorectal surgery to investigate the potential benefits of transversus abdominis plane blocks. These authors reported that (lateral) transversus abdominis…”

Section: Colorectal Surgerymentioning

confidence: 99%

Transversus Abdominis Plane Block

et al. 2019

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In this narrative review article, the authors discuss the anatomy, nomenclature, history, approaches (posterior vs. lateral vs. subcostal), techniques, pharmacology, indications, and complications of transversus abdominis plane blocks, as well as possible alternative truncal blocks. Despite the scarcity of evidence and contradictory findings, certain clinical suggestions can nonetheless be made. Overall transversus abdominis plane blocks appear most beneficial in the setting of open appendectomy (posterior or lateral approach). Lateral transversus abdominis plane blocks are not suggested for laparoscopic hysterectomy, laparoscopic appendectomy, or open prostatectomy. However, transversus abdominis plane blocks could serve as an analgesic option for Cesarean delivery (posterior or lateral approach) and open colorectal section (subcostal or lateral approach) if there exist contraindications to intrathecal morphine and thoracic epidural analgesia, respectively. Future investigation is required to compare posterior and subcostal transversus abdominis plane blocks in clinical settings. Furthermore, posterior transversus abdominis plane blocks should be investigated for surgical interventions in which their lateral counterparts have proven not to be beneficial (e.g., laparoscopic hysterectomy/appendectomy, open prostatectomy). More importantly, because posterior transversus abdominis plane blocks can purportedly provide sympathetic blockade and visceral analgesia, they should be compared with thoracic epidural analgesia for open colorectal surgery. Finally, transversus abdominis plane blocks should be compared with newer truncal blocks (e.g., erector spinae plane and quadratus lumborum blocks) with well-designed and adequately powered trials.

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Transversus abdominis plane block using a short-acting local anesthetic for postoperative pain after laparoscopic colorectal surgery: a systematic review and meta-analysis

Cited by 29 publications

References 39 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

Effect of different carbon dioxide (CO2) insufflation for laparoscopic colorectal surgery in elderly patients

Transversus Abdominis Plane Block

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