The analgesic efficacy of transversus abdominis plane block vs. wound infiltration after inguinal and infra-umbilical hernia repairs

Grape, Sina; Kirkham, Kyle R.; Albrecht, Éric

doi:10.1097/eja.0000000000001668

Cited by 6 publications

(3 citation statements)

References 27 publications

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“…Defined outcomes were extracted from each article following our routine approach previously described in meta-analyses on acute postoperative pain 11,12 . The primary outcome was the pain score at rest at 24 postoperative hours.…”

Section: Methodsmentioning

confidence: 99%

“…Defined outcomes were extracted from each article following our routine approach previously described in meta-analyses on acute postoperative pain. 11 , 12 The primary outcome was the pain score at rest at 24 postoperative hours. Secondary outcomes were rest pain scores at 2, 48 and 72 postoperative hours; interval morphine consumption at 24, 48 and 72 postoperative hours; presence of nausea or vomiting at 24, 48 and 72 postoperative hours; and hospital length of stay.…”

Section: Methodsmentioning

confidence: 99%

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The postoperative analgesic efficacy of liposomal bupivacaine versus long-acting local anaesthetics for peripheral nerve and field blocks

Nguyen

Grape

Gobbetti

et al. 2023

European Journal of Anaesthesiology

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BACKGROUNDLiposomal bupivacaine is claimed by the manufacturer to provide analgesia for up to 72 h postoperatively.OBJECTIVESTo compare the postoperative analgesic efficacy of liposomal bupivacaine versus long-acting local anaesthetics for peripheral nerve or field blocks.DESIGNA systematic review and meta-analysis with trial sequential analysis.DATA SOURCESMEDLINE, Embase and Web of Science, among others, up to June 2022.ELIGIBILITY CRITERIAWe retrieved randomised controlled trials comparing liposomal bupivacaine versus bupivacaine, levobupivacaine or ropivacaine for peripheral nerve and field blocks after all types of surgery. Our primary endpoint was rest pain score (analogue scale 0 to 10) at 24 h. Secondary endpoints included rest pain score at 48 and 72 h, and morphine consumption at 24, 48 and 72 h.RESULTSTwenty-seven trials including 2122 patients were identified. Rest pain scores at 24 h were significantly reduced by liposomal bupivacaine with a mean difference (95% CI) of -0.9 (-1.4 to -0.4), I2 = 87%, P < 0.001. This reduction in pain scores persisted at 48 h and 72 h with mean differences (95% CI) of -0.7 (-1.1 to -0.3), I2 = 82%, P = 0.001 and -0.7 (-1.1 to -0.3), I2 = 80%, P < 0.001, respectively. There were no differences in interval morphine consumption at 24 h (P = 0.15), 48 h (P = 0.15) and 72 h (P = 0.07). The quality of evidence was moderate.CONCLUSIONSThere is moderate level evidence that liposomal bupivacaine reduces rest pain scores by 0.9 out of 10 units, when compared with long-acting local anaesthetics at 24 hours after surgery, and by 0.7 up to 72 hours after surgery.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

The postoperative analgesic efficacy of liposomal bupivacaine versus long-acting local anaesthetics for peripheral nerve and field blocks

Nguyen

Grape

Gobbetti

et al. 2023

European Journal of Anaesthesiology

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“…spinal and epidural), as these may prolong time to postoperative mobilisation and discharge. Still, in patients with more than average pain risk, or laparoscopic procedures of more complexity and duration than usual, the use of different types of abdominal plane blocks may be appropriate, although the extra analgesia is modest [7,40,41]. Also, in some orthopaedic procedures with strong postoperative pain, for instance ankle surgery, a single shot block will provide good analgesia for the first hours after surgery.…”

Section: Regional Anesthetic and Analgesic Techniquesmentioning

confidence: 99%

Pain treatment and prophylaxis on pain

Ræder¹

2022

Current Opinion in Anaesthesiology

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Purpose of reviewAlso in ambulatory surgery, there will usually be a need for analgesic medication to deal with postoperative pain. Even so, a significant proportion of ambulatory surgery patients have unacceptable postoperative pain, and there is a need for better education in how to provide proper prophylaxis and treatment.Recent findingsPostoperative pain should be addressed both pre, intra- and postoperatively. The management should be with a multimodal nonopioid-based procedure specific guideline for the routine cases. In 10–20% of cases, there will be a need to adjust and supplement the basic guideline with extra analgesic measures. This may be because there are contraindications for a drug in the guideline, the procedure is more extensive than usual or the patient has extra risk factors for strong postoperative pain. Opioids should only be used when needed on top of multimodal nonopioid prophylaxis. Opioids should be with nondepot formulations, titrated to effect in the postoperative care unit and eventually continued only when needed for a few days at maximum.SummaryMultimodal analgesia should start pre or per-operatively and include paracetamol, nonsteroidal anti-inflammatory drug (NSAID), dexamethasone (or alternative glucocorticoid) and local anaesthetic wound infiltration, unless contraindicated in the individual case. Paracetamol and NSAID should be continued postoperatively, supplemented with opioid on top as needed. Extra analgesia may be considered when appropriate and needed. First-line options include nerve blocks or interfascial plane blocks and i.v. lidocaine infusion. In addition, gabapentinnoids, dexmedetomidine, ketamine infusion and clonidine may be used, but adverse effects of sedation, dizziness and hypotension must be carefully considered in the ambulatory setting.

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Laparoscopic-Guided Transversus Abdominis Plane (TAP) Block Combined with Port-Site Infiltration (PSI) for Laparoscopic Sleeve Gastrectomy in an ERABS Pathway: A Randomized, Prospective, Double-Blind, Placebo-Controlled Trial

Cataldo,

Bruni,

Migliorelli

et al. 2024

OBES SURG

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The analgesic efficacy of transversus abdominis plane block vs. wound infiltration after inguinal and infra-umbilical hernia repairs

Cited by 6 publications

References 27 publications

The postoperative analgesic efficacy of liposomal bupivacaine versus long-acting local anaesthetics for peripheral nerve and field blocks

The postoperative analgesic efficacy of liposomal bupivacaine versus long-acting local anaesthetics for peripheral nerve and field blocks

Pain treatment and prophylaxis on pain

Laparoscopic-Guided Transversus Abdominis Plane (TAP) Block Combined with Port-Site Infiltration (PSI) for Laparoscopic Sleeve Gastrectomy in an ERABS Pathway: A Randomized, Prospective, Double-Blind, Placebo-Controlled Trial

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