Transversus abdominis plane block for laparoscopic hysterectomy pain: A meta-analysis

Ja Hyun Shin, Ethan M. Balk, Karina Gritsenko, Alexander Wang, Kari Plewniak, Naum Shaparin

Research output: Contribution to journalReview article

Abstract

Objective: Review the analgesic effect of the transversus abdominis plane (TAP) block and its impact on postoperative pain scores and opioid usage for patients undergoing laparoscopic and robotic hysterectomies. Methods: Systematic review with meta-analysis of randomized controlled trials that compared the effect of TAP block to either placebo or no block on narcotic use (in morphine equivalent units [MEq]) and pain (per visual analog scale) within 24 h after a laparoscopic or robotic hysterectomy for benign or malignant indications. Searches were conducted in PubMed and Embase through May 31, 2019. Results: Nine randomized controlled trials met eligibility criteria; 7 evaluated laparoscopic hysterectomy and 2 robotic hysterectomy. A total of 688 subjects were included (559 laparoscopic hysterectomy, 129 robotic hysterec-tomy). Opioid consumption was similar in the first 24 h postoperative with or without TAP block (-0.8 MEq; 95% CI, -2.9, 1.3; 8 TAP arms; N = 395). Pain scores (visual analog scale) were also similar with or without TAP block (-0.01 U; 95% CI, -0.34, 0.32; 10 TAP arms; N = 636). Neither meta-analysis showed statistical heterogeneity across studies. Conclusions: The evidence does not support a benefit of TAP block to reduce pain or opioid use for patients receiving laparoscopic or robotic hysterectomies.

Original languageEnglish (US)
Article numbere2020.00018
Pages (from-to)1-9
Number of pages9
JournalJournal of the Society of Laparoendoscopic Surgeons
Volume24
Issue number2
DOIs
StatePublished - Apr 1 2020

Keywords

  • Hysterectomy
  • Laparoscopic
  • Robotic
  • TAP block, pain

ASJC Scopus subject areas

  • Surgery

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