O bloqueio do plano transverso abdominal subcostal pode melhorar a analgesia após colecistectomia laparoscópica

Vrsajkov, Vladimir; Mancic, N.; Mihajlović, D; Milićević, Suzana Tonković; Uvelin, Arsen; Vrsajkov, Jelena Pantić

doi:10.1016/j.bjan.2017.10.006

Cited by 13 publications

(5 citation statements)

References 15 publications

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“…16 Similar finding was reported by V.Vrsajkov et al (p<0.01). 21 In our study we found that differences in 24 hours VAS score was statistically significant. In study conducted by Suseela et al 22 with sample size of 40 in each group found ultrasound guided Subcostal TAP block is superior to port-site infiltration in providing post-operative analgesia after laparoscopic cholecystectomy with reduced pain scores(p<0.001) which is consistent with our study.…”

Section: Discussionsupporting

confidence: 50%

Efficacy of The Subcostal Transversus Abdominis Plane Block In Laparoscopic Cholecystectomy: A Comparison With Conventional Port- Site Infiltration

et al. 2020

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Introduction: Pain experienced following laparoscopic cholecystectomy derives significantly from incision made in anterior abdominal wall. Many patients experience moderate to severe pain following laparoscopic cholecystectomy. This study aimed to compare the efficacy of ultrasound guided bilateral subcostal transversus abdominal plane (TAP) block with port-site infiltration for post-operative analgesia after laparoscopic cholecystectomy. Methods: Sixty patients undergoing laparoscopic cholecystectomy were randomly allocated to two groups to receive port-site infiltration of local anaesthesia or ultrasound guided subcostal TAP block at the end of surgery before extubation. All patients received 1 gm paracetamol intravenously 8 hourly. Post-operative pain was assessed using visual analogue score at 0,1,2,4,8,16 and 24 hours. Time to first analgesic requirement and total opioid consumption over 24 hours were recorded. Results: Ultrasound guided bilateral subcostal transversus abdominis plane block significantly reduced post-operative pain score compared to port site infiltration. We observed statistically significant differences in visual analogue score between two groups at all other time frame. The 24 hours opioid consumption was less in Subcostal TAP (136±66.31μg VS 202±80.58μg, p=0.001). Time for rescue analgesia was prolonged in patient receiving subcostal TAP (3.63±2.09 hrs VS 1.73±1.60 hrs, p=0.0002). Conclusion: Ultrasound guided bilateral subcostal transversus abdominal block provides superior post-operative analgesia and reduced opioid consumption after laparoscopic cholecystectomy compared to port-site infiltration.

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Section: Discussionsupporting

confidence: 50%

Efficacy of The Subcostal Transversus Abdominis Plane Block In Laparoscopic Cholecystectomy: A Comparison With Conventional Port- Site Infiltration

et al. 2020

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“…In total, 22 of the included studies compared pre-operative TAP block with a control [ 22 , 23 , 25 , 27 – 29 , 31 , 33 , 35 – 43 , 45 , 46 , 49 , 52 , 54 ], 11 evaluated the effect of postoperative TAP block compared with a control block [ 24 , 26 , 30 , 32 , 34 , 44 , 47 , 48 , 50 , 51 , 53 ], and only one directly compared pre-operative TAP block with postoperative TAP block [ 11 ]. A total of 2317 patients were enrolled in the included trials: 456 patients were randomised to the postoperative TAP block group, 773 to the pre-operative TAP block group, and the remaining to the control group.…”

Section: Resultsmentioning

confidence: 99%

Analgesic benefits of pre-operative versus postoperative transversus abdominis plane block for laparoscopic cholecystectomy: a frequentist network meta-analysis of randomized controlled trials

Dost,

De Cassai,

Balzani

et al. 2023

BMC Anesthesiol

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Background Transversus abdominis plane (TAP) block has been utilized to alleviate pain following laparoscopic cholecystectomy (LC). However, the optimal timing of administration remains uncertain. This study aimed to compare the efficacy of pre-operative and postoperative TAP blocks as analgesic options after LC. Methods A frequentist network meta-analysis of randomized controlled trials (RCTs) was conducted. We systematically searched PubMed (via the National Library of Medicine), EMBASE, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science up to March 2023. The study included RCTs that enrolled adult patients (≥ 18 years) who underwent LC and received either pre-operative or postoperative TAP blocks. The primary outcome assessed was 24-hour postoperative morphine consumption (mg). Additionally, pain rest scores within 3 hours, 12 hours, and 24 hours, as well as postoperative nausea and vomiting (PONV), were considered as pre-specified secondary outcomes. Results A total of 34 trials with 2317 patients were included in the analysis. Postoperative TAP block demonstrated superiority over the pre-operative TAP block in reducing opioid consumption (MD 2.02, 95% CI 0.87 to 3.18, I2 98.6%, p < 0.001). However, with regards to postoperative pain, neither pre-operative nor postoperative TAP blocks exhibited superiority over each other at any of the assessed time points. The postoperative TAP block consistently ranked as the best intervention using SUCRA analysis. Moreover, the postoperative TAP block led to the most significant reduction in PONV. Conclusions The findings suggest that the postoperative TAP block may be slightly more effective in reducing 24-hour postoperative opioid consumption and PONV when compared to the pre-operative TAP block. Trial registration PROSPERO, CRD42023396880.

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“…For the primary outcome of pain control at rest and during coughing, out of 23 studies, 22 studies were included in the analysis for which references have been provided in Table 3 . Some of the included studies had reported data only for one or two timepoints for post-operative pain score either for 0 or 6 or 12 or 24 h at rest or during coughing ( 17 , 18 , 20 , 22 – 24 , 26 , 28 , 30 , 36 – 38 ). A single study by El-Dawlatly et al ( 27 ) only provided the data for morphine consumption.…”

Section: Resultsmentioning

confidence: 99%

“…A single study by El-Dawlatly et al ( 27 ) only provided the data for morphine consumption. PONV data was available for 12 studies ( 16 , 18 , 19 , 21 , 23 , 25 , 28 , 29 , 31 , 33 , 36 , 37 ) (750 LC patients). Information on morphine consumption up to 24 h post-operation was reported by seven studies ( 16 , 17 , 23 , 27 – 29 , 31 ) (348 LC subjects).…”

Section: Resultsmentioning

confidence: 99%

“…Analysis of 12 studies ( 16 , 18 , 19 , 21 , 23 , 25 , 28 , 29 , 31 , 33 , 36 , 37 ) involving 750 LC subjects showed a decreased incidence of PONV in patients receiving USG guided TAP blocks compared to control subjects (RR = 0.69, 95% CI: 0.54–0.89) ( Figure 5 ). No significant heterogeneity between the studies was observed ( I 2 = 9%, p = 0.36).…”

Section: Resultsmentioning

confidence: 99%

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A Meta-Analysis of Randomized Controlled Trials Concerning the Efficacy of Transversus Abdominis Plane Block for Pain Control After Laparoscopic Cholecystectomy

Wang

Gao

2021

Front. Surg.

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Background and Purpose: Transverse abdominis plane (TAP) block has been suggested to reduce post-operative pain after laparoscopic cholecystectomy (LC). However, the literature is divided on whether ultrasound (USG)-guided TAP block is effective for pain control after LC. The present meta-analysis therefore evaluated the efficacy of USG-guided TAP block vs. controls and port site infiltration for pain control after LC.Methods: A comprehensive literature search of online academic databases was performed for published randomized controlled trials (RCTs) for studies published to January 31, 2021. The primary outcome analyzed was post-operative pain score at 0, 6, 12, and 24 h post-surgery, both during rest and while coughing. Secondary outcomes included morphine consumption and post-operative nausea and vomiting (PONV) incidence.Results: A total of 23 studies with data on 1,450 LC patients were included in our meta-analysis. A reduction in pain intensity at certain post-operative timepoints was observed for USG-guided TAP block patients compared to control group patients. No reduction in pain intensity was observed for patients receiving USG-guided TAP block patients vs. conventional Port site infiltration.Conclusion: This meta-analysis concludes that TAP block is more effective than a conventional pain control, but not significatively different from another local incisional pain control that is port site infiltration. Additional prospective randomized controlled trials are required to further validate our findings.

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O bloqueio do plano transverso abdominal subcostal pode melhorar a analgesia após colecistectomia laparoscópica

Abstract: Our results show that subcostal transversus abdominis plane block can provide superior postoperative analgesia and reduction in opioid requirements after laparoscopic cholecystectomy.

Cited by 13 publications

References 15 publications

Efficacy of The Subcostal Transversus Abdominis Plane Block In Laparoscopic Cholecystectomy: A Comparison With Conventional Port- Site Infiltration

Efficacy of The Subcostal Transversus Abdominis Plane Block In Laparoscopic Cholecystectomy: A Comparison With Conventional Port- Site Infiltration

Analgesic benefits of pre-operative versus postoperative transversus abdominis plane block for laparoscopic cholecystectomy: a frequentist network meta-analysis of randomized controlled trials

A Meta-Analysis of Randomized Controlled Trials Concerning the Efficacy of Transversus Abdominis Plane Block for Pain Control After Laparoscopic Cholecystectomy

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