Your browser doesn't support javascript.
loading
Efficacy of Transversus Abdominis Plane Block in the Reduction of Pain and Opioid Requirement in Laparoscopic and Robot-assisted Hysterectomy: A Systematic Review and Meta-analysis / Eficácia do bloqueio transverso do plano abdominal na redução da dor e da necessidade de opioides em histerectomia laparoscópica e assistida por robô: Uma revisão sistemática e metanálise
López-Ruiz, Claudia; Orjuela, Jerutsa Catalina; Rojas-Gualdrón, Diego Fernando; Jimenez-Arango, Marcela; Ríos, José Fernando de los; Vásquez-Trespalacios, Elsa Maria; Vargas, Claudia.
Affiliation
  • López-Ruiz, Claudia; Clínica del Prado. Department of Gynecology and Obstetrics. Medellín. CO
  • Orjuela, Jerutsa Catalina; Clínica del Prado. Department of Gynecology and Obstetrics. Medellín. CO
  • Rojas-Gualdrón, Diego Fernando; CES University. School of Medicine. School of Graduate Studies. Medellín. CO
  • Jimenez-Arango, Marcela; CES University. School of Medicine. School of Graduate Studies. Medellín. CO
  • Ríos, José Fernando de los; Clínica del Prado. Department of Gynecology and Obstetrics. Medellín. CO
  • Vásquez-Trespalacios, Elsa Maria; CES University. School of Medicine. School of Graduate Studies. Medellín. CO
  • Vargas, Claudia; American Association of Gynecologic Laparoscopists. Medellín. CO
Rev. bras. ginecol. obstet ; 44(1): 55-66, Jan. 2022. tab, graf
Article in English | LILACS | ID: biblio-1365664
Responsible library: BR1.1
ABSTRACT
Abstract Objective To summarize the available evidence of TAP Block in efficacy in laparoscopic or robotic hysterectomy. Data Sources We searched databases and gray literature for randomized controlled trials in which transversus abdominis plane (TAP) block was compared with placebo or with no treatment in patients who underwent laparoscopic or robot-assisted hysterectomy. Method of Study Selection Two researchers independently evaluated the eligibility of the selected articles. Tabulation, Integration, and Results Seven studies were selected, involving 518 patients. Early postoperative pain showed a difference in the mean mean difference (MD) - 1.17 (95% confidence interval [CI] - 1.87-0.46) in pain scale scores (I2=68%), which was statistically significant in favor of using TAP block, but without clinical relevance; late postoperative pain DM 0.001 (95%CI - 0.43-0.44; I2=69%); opioid requirement DM 0.36 (95%CI - 0.94-1.68; I2=80%); and incidence of nausea and vomiting with a difference of 95%CI=- 0.11 (- 0.215-0.006) in favor of TAP. Conclusion With moderate strength of evidence, due to the high heterogeneity and imbalance in baseline characteristics among studies, the results indicate that TAP block should not be considered as a clinically relevant analgesic technique to improve postoperative pain in laparoscopic or robotic hysterectomy, despite statistical significance in early postoperative pain scale scores. Clinical Trial Number and Registry PROSPERO ID - CRD42018103573.
RESUMO
Resumo Objetivo Resumir as evidências disponíveis sobre a eficácia do bloqueio TAP em histerectomia laparoscópica ou robótica. Fontes de Dados Pesquisamos bancos de dados e literatura cinza por ensaios clínicos randomizados nos quais o bloqueio do plano transverso do abdome (TAP na sigla em inglês) foi comparado com placebo ou com nenhum tratamento em pacientes que foram submetidos a histerectomia laparoscópica ou assistida por robô. Métodos de Seleção de Estudos Dois pesquisadores avaliaram independentemente a elegibilidade dos artigos selecionados. Tabulação, Integração e Resultados Sete estudos foram selecionados envolvendo 518 pacientes. A dor pós-operatória precoce apresentou diferença nasmédias (DM) de -1 17 (intervalo de confiança [IC] de 95% - 1 87-0 46) nos escores da escala de dor (I2=68%) o que foi estatisticamente significativo a favor do uso do bloqueio TAP mas sem relevância clínica; dor pós-operatória tardia DM 0001 (IC95% - 043-044; I2=69%); necessidade de opioides DM0 36 (95%CI - 0 94-168; I2=80%); e incidência de náuseas e vômitos com diferença de 95% CI=- 011 (- 0215-0006) a favor do TAP. Conclusão Com moderada força de evidência devido à alta heterogeneidade e ao desequilíbrio nas características basais entre os estudos os resultados indicam que o bloqueio do TAP não deve ser considerado como uma técnica analgésica clinicamente relevante para melhorar a dor pós-operatória em histerectomia laparoscópica ou robótica apesar da significância estatística nas pontuações da escala de dor pósoperatória inicial. Número e Registro do Ensaio Clínico PROSPERO ID - CRD42018103573.
Subject(s)


Full text: Available Collection: International databases Health context: SDG3 - Health and Well-Being / SDG3 -Target 3.5 Prevention and treatment of consumption of psychoactive substances Health problem: Target 3.5: Prevention and treatment of consumption of psychoactive substances / Opioid Abuse Database: LILACS Main subject: Pain, Postoperative / Laparoscopy / Robotic Surgical Procedures / Analgesics, Opioid Type of study: Controlled clinical trial / Systematic review Language: English Journal: Rev. bras. ginecol. obstet Journal subject: Gynecology / Obstetrics Year: 2022 Document type: Article Affiliation country: Colombia Institution/Affiliation country: American Association of Gynecologic Laparoscopists/CO / CES University/CO / Clínica del Prado/CO

Full text: Available Collection: International databases Health context: SDG3 - Health and Well-Being / SDG3 -Target 3.5 Prevention and treatment of consumption of psychoactive substances Health problem: Target 3.5: Prevention and treatment of consumption of psychoactive substances / Opioid Abuse Database: LILACS Main subject: Pain, Postoperative / Laparoscopy / Robotic Surgical Procedures / Analgesics, Opioid Type of study: Controlled clinical trial / Systematic review Language: English Journal: Rev. bras. ginecol. obstet Journal subject: Gynecology / Obstetrics Year: 2022 Document type: Article Affiliation country: Colombia Institution/Affiliation country: American Association of Gynecologic Laparoscopists/CO / CES University/CO / Clínica del Prado/CO
...