Transversus Abdominis Plane Block in Laparoscopic Colorectal Surgery: A Systematic Review.
Dis Colon Rectum
; 62(10): 1248-1255, 2019 10.
Article
en En
| MEDLINE
| ID: mdl-31490834
ABSTRACT
BACKGROUND:
Multimodal analgesia is important for postoperative recovery in laparoscopic colorectal surgery. Multiple randomized controlled trials have investigated the use of transversus abdominis plane local anesthetic infiltration as a method of decreasing postoperative pain and opioid consumption, with variable results.OBJECTIVE:
This study aimed to examine the overall effect of transversus abdominis plane block in postoperative pain, opioid use, and speed of recovery in laparoscopic colorectal surgery. DATA SOURCES A literature search was done with PubMed, EMBASE, Web of Knowledge, and Cochrane Library. Only randomized controlled trials were selected for review.INTERVENTIONS:
Transversus abdominis plane local anesthetic infiltration versus no intervention, saline, or other techniques in laparoscopic colorectal surgeries was investigated. MAIN OUTCOMEMEASURES:
The primary outcome measured was postoperative pain on day 1, at rest or with activity. The secondary outcomes measured were postoperative pain beyond day 1, consumptions of opioid, and length of hospital stay.RESULTS:
Eight clinical trials including 649 patients between 2013 and 2018 were included. Resting pain scores within 2 hours (standardized mean difference, -0.53; p = 0.01), 4 hours (standardized mean difference, -0.42; p = 0.004), and 6 hours (standardized mean difference, -0.47; p = 0.03) showed statistically significant reduction. Six studies including 413 patients demonstrated lower cumulative opioid consumption within 24 hours after surgery (standardized mean difference, -0.82; p = 0.01). Five studies including 357 patients did not show a significant difference in length of stay (standardized mean difference, -0.04; p = 0.82).LIMITATIONS:
Local anesthetic used in block varied in type and quantity across different studies. There were heterogeneities in pain score measurements and opioid consumption. Patient populations may be different among studies.CONCLUSIONS:
Transversus abdominis block can lead to a lower pain score at rest within the first 6 hours and reduce opioid consumption within the first 24 hours. See Video Abstract at http//links.lww.com/DCR/A997.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Dolor Postoperatorio
/
Laparoscopía
/
Músculos Abdominales
/
Colectomía
/
Anestesia Local
/
Bloqueo Nervioso
Tipo de estudio:
Clinical_trials
/
Diagnostic_studies
/
Systematic_reviews
Límite:
Humans
Idioma:
En
Revista:
Dis Colon Rectum
Año:
2019
Tipo del documento:
Article