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Meta-Analysis
. 2024 Mar 1;24(1):87.
doi: 10.1186/s12871-024-02469-x.

Efficacy of transversus abdominis plane block on postoperative nausea and vomiting: a meta-analysis of randomized controlled trial

Jinfang Zeng #  1 , Aonan Hong #  2 , Zhen Gu  3 , Jinjin Jian  4 , Xiao Liang  5
Affiliations
Meta-Analysis

Efficacy of transversus abdominis plane block on postoperative nausea and vomiting: a meta-analysis of randomized controlled trial

Jinfang Zeng et al. BMC Anesthesiol. .

Abstract

Background: Postoperative nausea and vomiting (PONV) is a common postoperative complication, and Transversus abdominis plane (TAP) block can provide effective analgesia for surgical operation. However, but there is not enough evidence to prove its advantage for nausea and vomiting. The objective of this meta-analysis was to evaluate the efficacy of TAP block on PONV.

Methods: Two independent researchers conducted searches for randomized controlled trials (RCTs) in PubMed, Embase, and Cochrane Central Register of Controlled Trials. We used Review Manager software for meta-analysis.

Results: In this meta-analysis, twenty-six trials with 1981 patients were examined. The results showed that TAP block reduced postoperative nausea (Risk Difference (RD) = -0.10, 95% confidence interval (CI): -0.15 to -0.05) compared with no TAP block. TAP block reduced the dose of fentanyl (Standardized Mean Difference (SMD) = -1.17, 95% CI: -2.07 to -0.26) and morphine (SMD = -1.12, 95% CI: -2.10 to -0.13) compared with no TAP block, when the timing of administration was before surgery (RD = -0.13, 95% CI: -0.19 to -0.07). TAP block reduced postoperative nausea when the ropivacaine dosage is ≤ 100 mg (RD = -0.13, 95% CI: -0.21 to -0.06), bupivacaine dosage ≥ 100 mg ( RD = -0.08, 95% CI: -0.13 to -0.03), and when the ropivacaine concentration was ≤ 0.375% (RD = -0.11, 95% CI: -0.18 to -0.04). TAP block significantly reduced the incidence of nausea when the types of opioid drugs in PCA is tramadol (RD = -0.13, 95% CI: -0.24 to -0.03). TAP block could reduce the VAS (SMD= -0.99, 95% CI: -1.29 to -0.70) and reduce the time of extubation (SMD = -0.71, 95% CI: -1.34 to -0.08).

Conclusion: The meta-analysis conducted in this study revealed that TAP block could reduce the incidence of PONV, and the efficacy of TAP block may be influenced by factors such as administration time, local anesthetic dosage and concentration, types of opioid drugs in PCA.

Keywords: Meta-analysis; Nausea; Transversus abdominis plane; Vomiting.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of the inclusion and exclusion process
Fig. 2
Fig. 2
Summary of the risk of bias of the included studies
Fig. 3
Fig. 3
Results of the incidence of postoperative nausea (A) and vomiting (B)
Fig. 4
Fig. 4
Results of the Begg’s test and Egger’s test
Fig. 5
Fig. 5
Results VAS (A), the time of extubation (B), first flatus (C) and the duration in the hospital(D)
Fig. 6
Fig. 6
Results of the consumption of fentanyl (A), morphine (B), remifentanil (C) and sufentanil (D)
See this image and copyright information in PMC

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