Transversus Abdominis Plane Block Appears to Be Effective and Safe as a Part of Multimodal Analgesia in Bariatric Surgery: a Meta-analysis and Systematic Review of Randomized Controlled Trials

• Published in: Obesity surgery 2021-02, Vol.31 (2), p.531-543
• Main Authors: Földi, Mária, Soós, Alexandra, Hegyi, Péter, Kiss, Szabolcs, Szakács, Zsolt, Solymár, Margit, Pétervári, Erika, Balaskó, Márta, Kusza, Krzysztof, Molnár, Zsolt
• Format: Article
• Language: English
• Subjects: Abdominal Muscles - diagnostic imaging; Analgesia; Analgesics, Opioid; Bariatric Surgery; Clinical trials; Gastrointestinal surgery; Humans; Laparoscopy; Medicine; Medicine & Public Health; Meta-analysis; Narcotics; Obesity, Morbid - surgery; Original Contributions; Pain, Postoperative - drug therapy; Randomized Controlled Trials as Topic; Recovery (Medical); Surgery
• ISSN: 0960-8923; 1708-0428
• DOI: 10.1007/s11695-020-04973-8

Purpose Pain after bariatric surgery can prolong recovery. This patient group is highly susceptible to opioid-related side effects. Enhanced Recovery After Surgery guidelines strongly recommend the administration of multimodal medications to reduce narcotic consumption. However, the role of ultrasound-guided transversus abdominis plane (USG-TAP) block in multimodal analgesia of weight loss surgeries remains controversial. Materials and Methods A systematic search was performed in four databases for studies published up to September 2019. We considered randomized controlled trials that assessed the efficacy of perioperative USG-TAP block as a part of multimodal analgesia in patients with laparoscopic bariatric surgery. Results Eight studies (525 patients) were included in the meta-analysis. Pooled analysis showed lower pain scores with USG-TAP block at every evaluated time point and lower opioid requirement in the USG-TAP block group (weighted mean difference (WMD) = − 7.59 mg; 95% CI − 9.86, − 5.39; p