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. 2021 Aug 4:8:700318.
doi: 10.3389/fsurg.2021.700318. eCollection 2021.

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

Weihua Wang  1 , Lishan Wang  2 , Yan Gao  1
Affiliations

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

Weihua Wang et al. Front Surg. .

Abstract

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.

Keywords: analgesia; laparoscopic cholecystectomy; pain control; transverse abdominis plane block; ultrasound.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram for the selection of studies and specific reasons for exclusion from the present meta-analysis.
Figure 2
Figure 2
(A–D) Forest plot representing for Pain Intensity at Rest for USG guided TAP block vs. control group at (A) 0 h; (B) 6 h; (C) 12 h and (D) 24 h timepoints after operation.
Figure 3
Figure 3
(A–D) Forest plot representing for Pain Intensity after operation during coughing for USG TAP block vs. control group (A) 0 h; (B) 6 h; (C) 12 h and (D) 24 h.
Figure 4
Figure 4
Forest plot representing for morphine consumption in the recovery room USG guided TAP block vs. control group.
Figure 5
Figure 5
Forest plot representing for adverse events (PONV) in USG guided TAP block vs. control group.
See this image and copyright information in PMC

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