Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Feb 23:8:802039.
doi: 10.3389/fmed.2021.802039. eCollection 2021.

Transversus Abdominis Plane Block in Colorectal Surgery: A Meta-Analysis

Dmitriy Viderman  1 , Mina Aubakirova  1 , Yerkin G Abdildin  2
Affiliations

Transversus Abdominis Plane Block in Colorectal Surgery: A Meta-Analysis

Dmitriy Viderman et al. Front Med (Lausanne). .

Abstract

Acute postoperative pain is one of the most common concerns during the early postoperative period in colorectal surgery. Opioids still represent the cornerstone of postoperative pain management, yet they often result in significant side effects such as nausea and/or vomiting, sedation, urinary retention, delayed recovery of colonic motility, respiratory depression, and postoperative ileus. Transversus abdominis plane (TAP) block has been widely used for postoperative analgesia in various abdominal surgeries. The primary aim of this meta-analysis was to compare the postoperative opioid requirements of patients in the TAP block group and the control group (placebo). The secondary aims included evaluation of the efficacy of TAP blocks in postoperative pain management, the measurement of time to first request for opioids, the measurement of length of hospital stay (LoS), and the documentation of postoperative nausea and/or vomiting. We searched for articles reporting the results of randomized controlled trials (RCTs) on the application of TAP block in colorectal surgery published before September 2021. Eight RCTs involving 615 patients were included in the meta-analysis. Seven articles reported the results of TAP blocks in laparoscopic surgery and eight in both laparoscopic and open surgery. The need for opioids and the intensity of pain at rest within 24 h after laparoscopic and combined (laparoscopic and open) surgeries were significantly lower in the TAP block group compared with the "no block" group. The intensity of pain during coughing within 24 hours after laparoscopic surgery was significantly lower in the TAP block groups compared to the groups without block. There were no statistically significant differences between the TAP block and "no block" groups in overall (over the entire hospital stay) postoperative opioid consumption and length of hospital stay after laparoscopic surgery, as well as in postoperative nausea and vomiting after laparoscopic and combined surgeries.

Keywords: colorectal surgery; opioid consumption; postoperative pain management; regional anesthesia; transversus abdominis plane (TAP) block.

PubMed Disclaimer

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
PRISMA diagram.
Figure 2
Figure 2
Forest plot for total opioid consumption within 24 h after surgery in mg of morphine (only laparoscopic surgeries).
Figure 3
Figure 3
Forest plot for total opioid consumption within 24 h after surgery in mg of morphine (laparoscopic and open surgeries).
Figure 4
Figure 4
Forest plot for overall postoperative opioid consumption in mg of morphine (laparoscopic surgeries).
Figure 5
Figure 5
Forest plot for the pain intensity score in NRS/VAS at rest recorded 24 h after laparoscopic surgery.
Figure 6
Figure 6
Forest plot for the pain intensity score in NRS/VAS at rest recorded 24 h after laparoscopic and open surgeries.
Figure 7
Figure 7
Forest plot for the pain intensity score in NRS/VAS when coughing recorded 24 h after open and laparoscopic surgeries.
Figure 8
Figure 8
Forest plot on length of hospital stay after laparoscopic surgery.
Figure 9
Figure 9
Forest plot on postoperative nausea and vomiting (laparoscopic surgery).
Figure 10
Figure 10
Forest plot on postoperative nausea and vomiting (laparoscopic and open surgeries).
See this image and copyright information in PMC

References

    1. Liu S. Anesthesia and analgesia for colon surgery. Region Anesth Pain M. (2004) 29:52–7. 10.1016/j.rapm.2003.10.019 - DOI - PubMed
    1. Bonnet F, Marret E. Influence of anaesthetic and analgesic techniques on outcome after surgery. Brit J Anaesth. (2005) 95:52–8. 10.1093/bja/aei038 - DOI - PubMed
    1. Kehlet H, Rung G, Callesen T. Postoperative opioid analgesia: time for a reconsideration? J Clin Anesth. (1996) 8:441–5. 10.1016/0952-8180(96)00131-6 - DOI - PubMed
    1. Cali R, Meade P, Swanson M, Freeman C. Effect of morphine and incision length on bowel function after colectomy. Dis Colon Rectum. (2000) 43:163–8. 10.1007/BF02236975 - DOI - PubMed
    1. Lassen K, Hannemann P, Ljungqvist O, Fearon K, Dejong C, von Meyenfeldt M, et al. Patterns in current perioperative practice: survey of colorectal surgeons in five northern European countries. BMJ. (2005) 330:1420–1. 10.1136/bmj.38478.568067.AE - DOI - PMC - PubMed

Publication types