The analgesic efficacy compared ultrasound-guided continuous transverse abdominis plane block with epidural analgesia following abdominal surgery: a systematic review and meta-analysis of randomized controlled trials

• Published in: BMC anesthesiology 2020-02, Vol.20 (1), p.52-52, Article 52
• Main Authors: Qin, Chaosheng, Liu, Yuanming, Xiong, Jijun, Wang, Xiaogang, Dong, Qinghua, Su, Tingshi, Liu, Jingchen
• Format: Article
• Language: English
• Subjects: Abdomen; Abdomen - surgery; Abdominal Muscles - diagnostic imaging; Abdominal Muscles - innervation; Abdominal surgery; Analgesia; Analgesia, Epidural - methods; Analgesics; Analgesics - therapeutic use; Bias; Catheters; Clinical trials; Collaboration; Comparative analysis; Drug dosages; Epidural analgesia; Humans; Inflammation; Meta-analysis; Morphine; Narcotics; Nerve Block - methods; Nonsteroidal anti-inflammatory drugs; Pain; Pain management; Pain perception; Pain, Postoperative - drug therapy; Postoperative pain; Randomized Controlled Trials as Topic; Steroidal anti-inflammatory agents; Surgery; Systematic review; TAP block; Time; Treatment Outcome; Ultrasonic imaging; Ultrasonography, Interventional - methods; Ultrasound
• ISSN: 1471-2253; 1471-2253
• DOI: 10.1186/s12871-020-00969-0

This review and meta-analysis aims to evaluate the analgesic efficacy of continuous transversus abdominis plane (TAP) block compared with epidural analgesia (EA) in adults after abdominal surgery. The databases PubMed, Embase and Cochrane Central Register were searched from inception to June 2019 for all available randomized controlled trials (RCTs) that evaluated the analgesic efficacy of continuous TAP block compared with EA after abdominal surgery. The weighted mean differences (WMDs) were estimates for continuous variables with a 95% confidence interval (CI) and risk ratio (RR) for dichotomous data. The pre-specified primary outcome was the dynamic pain scores 24 h postoperatively. Eight trials including 453 patients (TAP block:224 patients; EA: 229 patients) ultimately met the inclusion criteria and seven trials were included in the meta-analysis. Dynamic pain scores after 24 h were equivalent between TAP block and EA groups (WMD:0.44; 95% CI: 0.1 to 0.99; I  = 91%; p = 0.11). The analysis showed a significant difference between the subgroups according to regularly administering (4 trials; WMD:-0.11; 95% CI: - 0.32 to 0.09; I  = 0%; p = 0.28) non-steroidal anti-inflammatory drugs (NSAIDs) or not (3 trials; WMD:1.02; 95% CI: 0.09 to 1.96; I  = 94%; p = 0.03) for adjuvant analgesics postoperatively. The measured time of the urinary catheter removal in the TAP group was significantly shorter (3 trials, WMD:-18.95, 95% CI:-25.22 to - 12.71; I  = 0%; p