Author/Authors :
Peng, Ke First Affiliated Hospital of Soochow University - Department of Anesthesiology, China , Ji, Fu-hai First Affiliated Hospital of Soochow University - Department of Anesthesiology, China , Liu, Hua-yue First Affiliated Hospital of Soochow University - Department of Anesthesiology, China , Wu, Shao-ru First Affiliated Hospital of Soochow University - Department of Anesthesiology, China
Abstract :
Objectives: To evaluate the analgesic efficacy of ultrasound- guided transversus abdominis plane (TAP) block for patients undergoing laparoscopic cholecystectomy (LC). Materials and Methods: A systematic literature search was conducted to identify randomized controlled trials that compared ultrasound-guided TAP block with control for analgesia in adult patients undergoing LC. The original data were pooled for the meta-analysis using Review Manager 5. The main outcomes included postoperative pain intensity, opioid consumption, and adverse events. Out of a total of 77 trials, 7 were included. Results: Compared with control, ultrasound-guided TAP block reduced the following: (1) postoperative pain intensity (visual analog scale: 0–10) both at rest and on movement at 0, 2, 4, 8, and 24 h (at rest: mean difference, MD 0 h = –2.19, 95% confidence interval, CI: –3.46 to –0.91, p = 0.0008; on movement: MD 0 h = –2.67, 95% CI: –3.86 to –1.48, p 0.0001); (2) intraoperative fentanyl consumption (MD = –27.85 μg, 95% CI: –44.91 to –10.79, p = 0.001), and (3) morphine consumption in the recovery room (MD = –1.57 mg, 95% CI: –3.0 to –0.14, p = 0.03) and 0–24 h postoperatively. Fewer patients required analgesics in the recovery room when receiving TAP blocks (risk ratio, RR = 0.35, 95% CI: 0.20 to 0.62, p = 0.0003). TAP blocks also reduced postoperative nausea and vomiting (RR = 0.48, 95% CI: 0.28 to 0.81, p = 0.006). None of the studies reported symptoms of local anesthetic toxicity. Conclusions: In this study, the ultrasound-guided TAP block was an effective strategy for analgesia in patients undergoing LC.
