A meta-analysis on the clinical effectiveness of transversus abdominis plane block

J Clin Anesth. 2011 Feb;23(1):7-14. doi: 10.1016/j.jclinane.2010.05.008.

Abstract

Study objective: To study the efficacy of the transversus abdominal plane (TAP) block.

Design: Meta-analysis.

Setting: District general hospital.

Patients: 86 patients in the TAP block group and 88 in the non-TAP block group.

Measurements: Statistical analyses were performed using Microsoft Excel 2007 for Windows XP. Hedges g statistic was used for the calculation of standardized mean differences (SMD). Binary data (nausea) were summarized as risk ratios (RR).

Main results: Patients with TAP block required less morphine after 24 hours than those who did not have the block (random effects model: SMD -4.81, 95% CI [-7.45, -2.17], z = -3.57, P < 0.001). There was less time to first request of morphine in the non-TAP block group (random effects model: SMD 4.80, 95% CI [2.16, 7.43], z = 3.57, P < 0.001). Patients in the TAP block group had less pain up to 24 hours postoperatively. No statistical differences were found with respect to nausea.

Conclusions: TAP block reduces the need for postoperative opioid use, it increases the time first request for further analgesia, it provides more effective pain relief, and it reduces opioid-associated side effects.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Abdomen* / surgery
  • Analgesia
  • Analgesics, Opioid / adverse effects
  • Analgesics, Opioid / therapeutic use
  • Anesthetics, Local
  • Critical Care
  • Humans
  • Laparoscopy
  • Laparotomy
  • Morphine / adverse effects
  • Morphine / therapeutic use
  • Nerve Block*
  • Pain Measurement / drug effects
  • Pain, Postoperative / diagnosis
  • Pain, Postoperative / drug therapy
  • Pain, Postoperative / epidemiology*
  • Postoperative Nausea and Vomiting / epidemiology
  • Randomized Controlled Trials as Topic
  • Treatment Outcome

Substances

  • Analgesics, Opioid
  • Anesthetics, Local
  • Morphine