Unilateral transversus abdominis plane block and port-site infiltration

Arık, Emine; Akkaya, Taylan; Ozciftci, Serhat; Alptekin, Alp; Balas, Şener

doi:10.1007/s00101-020-00746-1

Cited by 17 publications

(13 citation statements)

References 27 publications

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“…It is noteworthy that a similar pattern of changes, in which the US-TAP block group had a lower pain experience and analgesic requirement compared with the port infiltration groups, was observed in a study by Khandelwal, Parag, Singh, Anand, and Govil [ 82 ] and by Arık, Akkaya, Ozciftci, Alptekin, and Balas [ 86 ]. A similar pattern of changes was observed and the time to rescue analgesia was equally longer in patients receiving subcostal US-TAP block (3.63 h) compared to the port infiltration group (1.73 h, p = 0.0002) [ 87 ].…”

Section: Study Characteristicssupporting

confidence: 65%

Transversus Abdominis Plane Block as a Strategy for Effective Pain Management in Patients with Pain during Laparoscopic Cholecystectomy: A Systematic Review

Alsharari

Abuadas

Alnassrallah

et al. 2022

JCM

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Laparoscopic cholecystectomy (LC), unlike laparotomy, is an invasive surgical procedure, and some patients report mild to moderate pain after surgery. Transversus abdominis plane (TAP) block has been shown to be an appropriate method for postoperative analgesia in patients undergoing abdominal surgery. However, there have been few studies on the efficacy of TAP block after LC surgery, with unclear information on the optimal dose, long-term effects, and clinical significance, and the analgesic efficacy of various procedures, hence the need for this review. Five electronic databases (PubMed, Academic Search Premier, Web of Science, CINAHL, and Cochrane Library) were searched for eligible studies published from inception to the present. Post-mean and standard deviation values for pain assessed were extracted, and mean changes per group were calculated. Clinical significance was determined using the distribution-based approach. Four different local anesthetics (Bupivacaine, Ropivacaine, Lidocaine, and Levobupivacaine) were used at varying concentrations from 0.2% to 0.375%. Ten different drug solutions (i.e., esmolol, Dexamethasone, Magnesium Sulfate, Ketorolac, Oxycodone, Epinephrine, Sufentanil, Tropisetron, normal saline, and Dexmedetomidine) were used as adjuvants. The optimal dose of local anesthetics for LC could be 20 mL with 0.4 mL/kg for port infiltration. Various TAP procedures such as ultrasound-guided transversus abdominis plane (US-TAP) block and other strategies have been shown to be used for pain management in LC; however, TAP blockade procedures were reported to be the most effective method for analgesia compared with general anesthesia and port infiltration. Instead of 0.25% Bupivacaine, 1% Pethidine could be used for the TAP block procedures. Multimodal analgesia could be another strategy for pain management. Analgesia with TAP blockade decreases opioid consumption significantly and provides effective analgesia. Further studies should identify the long-term effects of different TAP block procedures.

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Section: Study Characteristicssupporting

confidence: 65%

Transversus Abdominis Plane Block as a Strategy for Effective Pain Management in Patients with Pain during Laparoscopic Cholecystectomy: A Systematic Review

Alsharari

Abuadas

Alnassrallah

et al. 2022

JCM

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“…All included studies were of moderate or high quality based on JADAD Score ( Table 2 ). Out of 23 included studies, 14 studies ( 16 – 18 , 23 – 25 , 27 , 30 , 31 , 34 – 38 , 40 ) were conducted in Caucasian individuals, with the remaining nine studies ( 19 – 22 , 26 , 28 , 29 , 32 , 33 ) were conducted on an Asian population.…”

Section: Resultsmentioning

confidence: 99%

“…A single study by El-Dawlatly et al ( 27 ) only provided the data for morphine consumption. PONV data was available for 12 studies ( 16 , 18 , 19 , 21 , 23 , 25 , 28 , 29 , 31 , 33 , 36 , 37 ) (750 LC patients). Information on morphine consumption up to 24 h post-operation was reported by seven studies ( 16 , 17 , 23 , 27 – 29 , 31 ) (348 LC subjects).…”

Section: Resultsmentioning

confidence: 99%

“…Analysis of 12 studies ( 16 , 18 , 19 , 21 , 23 , 25 , 28 , 29 , 31 , 33 , 36 , 37 ) involving 750 LC subjects showed a decreased incidence of PONV in patients receiving USG guided TAP blocks compared to control subjects (RR = 0.69, 95% CI: 0.54–0.89) ( Figure 5 ). No significant heterogeneity between the studies was observed ( I 2 = 9%, p = 0.36).…”

Section: Resultsmentioning

confidence: 99%

“…Analysis of seven studies (16,17,23,(27)(28)(29)31) involving 348 LC subjects showed a significant reduction in morphine consumption during the first 24 h after surgery (MD = −1.76 mg, 95% CI: −3.28 to −0.24) in patients receiving TAP blocks compared to control subjects (Figure 4). A high degree of heterogeneity was observed (I 2 = 91%, p < 0.0001).…”

Section: Morphine Consumption During 24 H After Operationmentioning

confidence: 99%

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A Meta-Analysis of Randomized Controlled Trials Concerning the Efficacy of Transversus Abdominis Plane Block for Pain Control After Laparoscopic Cholecystectomy

Wang

Gao

2021

Front. Surg.

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Background and Purpose: Transverse abdominis plane (TAP) block has been suggested to reduce post-operative pain after laparoscopic cholecystectomy (LC). However, the literature is divided on whether ultrasound (USG)-guided TAP block is effective for pain control after LC. The present meta-analysis therefore evaluated the efficacy of USG-guided TAP block vs. controls and port site infiltration for pain control after LC.Methods: A comprehensive literature search of online academic databases was performed for published randomized controlled trials (RCTs) for studies published to January 31, 2021. The primary outcome analyzed was post-operative pain score at 0, 6, 12, and 24 h post-surgery, both during rest and while coughing. Secondary outcomes included morphine consumption and post-operative nausea and vomiting (PONV) incidence.Results: A total of 23 studies with data on 1,450 LC patients were included in our meta-analysis. A reduction in pain intensity at certain post-operative timepoints was observed for USG-guided TAP block patients compared to control group patients. No reduction in pain intensity was observed for patients receiving USG-guided TAP block patients vs. conventional Port site infiltration.Conclusion: This meta-analysis concludes that TAP block is more effective than a conventional pain control, but not significatively different from another local incisional pain control that is port site infiltration. Additional prospective randomized controlled trials are required to further validate our findings.

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Regional anaesthesia for postoperative pain management following laparoscopic, visceral, non-oncological surgery a systematic review and meta-analysis

Lohmöller,

Carstensen,

Pogatzki-Zahn

et al. 2024

Surg Endosc

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Unilateral transversus abdominis plane block and port-site infiltration

Cited by 17 publications

References 27 publications

Transversus Abdominis Plane Block as a Strategy for Effective Pain Management in Patients with Pain during Laparoscopic Cholecystectomy: A Systematic Review

Transversus Abdominis Plane Block as a Strategy for Effective Pain Management in Patients with Pain during Laparoscopic Cholecystectomy: A Systematic Review

A Meta-Analysis of Randomized Controlled Trials Concerning the Efficacy of Transversus Abdominis Plane Block for Pain Control After Laparoscopic Cholecystectomy

Regional anaesthesia for postoperative pain management following laparoscopic, visceral, non-oncological surgery a systematic review and meta-analysis

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