Ultrasound-guided vs Laparoscopic-asisted Transversus Abdominis Plane Block for Laparoscopic Cholecystectomy: A Randomized Prospective Study

Sahap, Mehmet; Artykov, Merve Sevim; Güleç, Handan; Yalçın, Abdussamed; But, Abdülkadir

doi:10.54875/jarss.2023.79106

Cited by 2 publications

(1 citation statement)

References 16 publications

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“…Similarly, Sahap et al [52] reported no significant difference between the LTAP and UTAP groups regarding hemodynamic measurements, tramadol consumption, VAS score, and PONV in the post-operative period in patients who underwent LAP cholecystectomy.…”

Section: Discussionmentioning

confidence: 93%

Laparoscopic assisted versus ultrasound guided transversus abdominis plane block in laparoscopic bariatric surgery: a randomized controlled trial

Algyar,

Abdelsamee

2024

BMC Anesthesiol

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Background Transversus abdominis plane block (TAPB) guided by laparoscopy and ultrasound showed promise in enhancing the multimodal analgesic approach following several abdominal procedures. This study aimed to compare the efficacy and safety between Laparoscopic (LAP) TAP block (LTAP) and ultrasound-guided TAP block (UTAP) block in patients undergoing LAP bariatric surgery. Patients and methods This non-inferiority randomized controlled single-blind study was conducted on 120 patients with obesity scheduled for LAP bariatric surgeries. Patients were allocated into two equal groups: LTAP and UTAP, administered with 20 mL of 0.25% bupivacaine on each side. Results There was no statistically significant difference in the total morphine consumption, Visual Analogue Scale (VAS) score at all times of measurements, and time to the first rescue analgesia (p > .05) between both groups. The duration of anesthesia and duration of block performance were significantly shorter in the LTAP group than in the UTAP group (p < .001). Both groups had comparable post-operative heart rate, mean arterial pressure, adverse effects, and patient satisfaction. Conclusions In LAP bariatric surgery, the analgesic effect of LTAP is non-inferior to UTAP, as evidenced by comparable time to first rescue analgesia and total morphine consumption with similar safety blocking through the low incidence of post-operative complications and patient satisfaction. Trial registration The study was registered in Pan African Clinical Trials Registry (PACTR) (ID: PACTR202206871825386) on June 29, 2022.

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Section: Discussionmentioning

confidence: 93%

Laparoscopic assisted versus ultrasound guided transversus abdominis plane block in laparoscopic bariatric surgery: a randomized controlled trial

Algyar,

Abdelsamee

2024

BMC Anesthesiol

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Laparoscopic-assisted versus ultrasound-guided transversus abdominis plane block for laparoscopic cholecystectomy: a systematic review and meta-analysis

Ghani,

Hussain,

Wahid

et al. 2024

BMC Surg

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Background Laparoscopic-assisted (LTAP) and ultrasound-guided (UTAP) transversus abdominis plane (TAP) blocks are widely used for postoperative analgesia in laparoscopic cholecystectomy (LC), yet their comparative effectiveness remains unclear. The aim of this meta-analysis was to systematically evaluate and compare postoperative outcomes of LTAP and UTAP in LC. Materials and methodology A comprehensive literature search of five electronic databases was conducted from the inception of the paper till 2 June 2024 following PRISMA guidelines. Eligibility criteria included: (a) randomized controlled trials (RCTs); (b) adult patients (≥ 18 years) undergoing elective LC; (c) intervention group undergoing LTAP; (d) control group receiving UTAP; (e) outcomes: postoperative pain intensity using VAS score; time to first analgesic need; postoperative morphine consumption; postoperative nausea vomiting (PONV); time to first bowel evacuation; time to first flatus. Mendeley Desktop 1.19.8 was used for article retrieval and for the removal of duplicates. Risk of bias was assessed using the Cochrane Risk of Bias Tool, and statistical analysis was performed using Review Manager, applying a random-effects model. Forest plots represented combined effects of Risk Ratios (RRs) for dichotomous outcomes and weighted mean differences (WMDs) for continuous outcomes with a 95% confidence interval (CI). P-value ≤ 0.05 was considered statistically significant and Higgin’s I² test was employed to assess heterogeneity. Results Seven RCTs in total involving 603 patients were included in the analysis, with 236 patients in the LTAP group and 232 in the UTAP group. No statistically significant differences observed between LTAP and UTAP in postoperative pain intensity at 6, 12, and 24 h, time to first analgesic need, postoperative morphine consumption, PONV, time to first stools, and time to first flatus, initially. Sensitivity analysis revealed a significant reduction in 6-hour postoperative pain in the LTAP group (WMD = 0.39; 95% CI = 0.10,0.67; P = 0.008; I² = 0%), but no significant differences were found in later time points (12 h: WMD = 0.12; 95% CI = -0.17,0.40; P = 0.42; I² = 0%; 24 h: WMD = -0.04; 95% CI = -0.26, 0.18; P = 0.73; I² = 5%) or in other outcomes. Moderate levels of heterogeneity and an overall low risk of bias in quality assessment were observed among the studies. Conclusion Our meta-analysis indicated no clear advantage of LTAP over UTAP in managing postoperative pain and related outcomes in LC. Although LTAP may offer logistical benefits by reducing the need for equipment and personnel, further large-scale RCTs focusing on procedure-specific outcomes are needed to establish definitive conclusions.

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Ultrasound-guided vs Laparoscopic-asisted Transversus Abdominis Plane Block for Laparoscopic Cholecystectomy: A Randomized Prospective Study

Cited by 2 publications

References 16 publications

Laparoscopic assisted versus ultrasound guided transversus abdominis plane block in laparoscopic bariatric surgery: a randomized controlled trial

Laparoscopic assisted versus ultrasound guided transversus abdominis plane block in laparoscopic bariatric surgery: a randomized controlled trial

Laparoscopic-assisted versus ultrasound-guided transversus abdominis plane block for laparoscopic cholecystectomy: a systematic review and meta-analysis

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