Transversus abdominis plane block for laparoscopic colorectal surgery: A meta-analysis of randomised controlled trials

Liu, Kaiyuan; Lu, Yen-Jung; Lin, Yu-Cih; Wei, Po‐Li; Kang, Yi‐No

doi:10.1016/j.ijsu.2022.106825

Cited by 14 publications

(11 citation statements)

References 57 publications

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“…The length of stay did not differ between groups in accordance with all recent meta-analyses published in the literature [3,7,23].…”

Section: Discussionsupporting

confidence: 88%

“…We and meta-analyses compared with control groups [3,7,23]. We did not experience any complications related to either laparoscopic or ultrasound-guided techniques.…”

Section: Discussionmentioning

confidence: 92%

“…We have not used a control arm in our study because of the widespread use of TAP block and its efficacy in reducing postoperative pain and opioid consumption, shown in multiple studies and meta‐analyses compared with control groups [3, 7, 23]. We did not experience any complications related to either laparoscopic or ultrasound‐guided techniques.…”

Section: Discussionmentioning

confidence: 99%

“…Delivery can be achieved under ultrasound guidance performed by the anaesthetist or under laparoscopic control performed by the surgeon. In colorectal surgery, the efficacy of the TAP block in reducing overall pain and opioid consumption has been shown in multiple randomized controlled trials and meta‐analyses, which compared patients treated with this technique to control groups who receive classic postoperative analgesia [7].…”

Section: Introductionmentioning

confidence: 99%

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Laparoscopic versus ultrasound‐guided transversus abdominis plane block in colorectal surgery: a non‐inferiority, multicentric randomized double‐blinded clinical trial

et al. 2023

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AimThe aim of this study was to assess if laparoscopic‐assisted transversus abdominis plane (TAP) block (L‐TAPB) is as efficient as ultrasound‐guided TAP block (U‐TAPB) in postoperative pain control.MethodIn all, 112 patients scheduled for elective laparoscopic colon resection from February 2018 to December 2021 at two Swiss hospitals were included and randomized in a 1:1 ratio before surgery with either L‐TAPB or U‐TAPB. The primary end‐point was the non‐inferiority of the L‐TAPB compared to U‐TAPB with regard to the total opioid consumption within the first 24 h after surgery. Data regarding patients' characteristics, opioid consumption, pain on the visual analogue scale, operative and anaesthesia induction time, complications and length of stay were collected and analysed.ResultsFifty‐five patients were allocated to the L‐TAPB and fifty‐seven to the U‐TAPB. No significant difference was found in the overall dose of opioids within 24 h, and the non‐inferiority of the L‐TAPB was confirmed. There were almost twice as many patients in the L‐TAPB group requesting opioid reserves compared to the U‐TAPB group (54.5% vs. 29.8%, P = 0.008). The anaesthesia induction time was significantly longer in the U‐TAPB group (17 ± 11 min vs. 23 ± 12 min, P = 0.014). For all other variables (pain on the visual analogue scale, opioid consumption, need of epidural analgesia, operating time, postoperative complications and hospital stay) no statistically significant difference between the L‐TAPB and the U‐TAPB groups was noted.ConclusionOur results showed the non‐inferiority of the laparoscopic delivery compared to ultrasound‐guided administration of the TAP block, with the advantage of not affecting anaesthesia times.Study registration number2017‐02017 CE 3294, ClinicalTrials.gov identifier NCT04575233.

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“…The length of stay did not differ between groups in accordance with all recent meta-analyses published in the literature [3,7,23].…”

Section: Discussionsupporting

confidence: 88%

“…We and meta-analyses compared with control groups [3,7,23]. We did not experience any complications related to either laparoscopic or ultrasound-guided techniques.…”

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Laparoscopic versus ultrasound‐guided transversus abdominis plane block in colorectal surgery: a non‐inferiority, multicentric randomized double‐blinded clinical trial

et al. 2023

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“…New items reducing perioperative stress and invasiveness of surgery have been subsequently proposed [ 9 , 10 ]. Promising preliminary results have been obtained with low-pressure pneumoperitoneum, multimodal analgesia including abdominal wall blocks, and inferior mesenteric artery preservation in upper rectal cancer surgery [ 11 , 12 , 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Early Postoperative Low Compliance to Enhanced Recovery Pathway in Rectal Cancer Patients

Ceresoli

Pedrazzani

Pellegrino

et al. 2022

Cancers

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Early postoperative low compliance to enhanced recovery protocols has been associated with morbidity following colon surgery. The purpose of this study is to evaluate the possible causes of early postoperative low compliance to the enhanced recovery pathway and its relationship with morbidity following rectal surgery for cancer. A total of 439 consecutive patients who underwent elective surgery for rectal cancer have been included in the study. Compliance to enhanced recovery protocol on postoperative day (POD) 2 was evaluated in all patients. Indicators of compliance were naso-gastric tube and urinary catheter removal, recovery of both oral feeding and mobilization, and the stopping of intravenous fluids. Low compliance on POD 2 was defined as non- adherence to two or more items. One-third of patients had low compliance on POD 2. Removal of urinary catheter, intravenous fluids stop, and mobilization were the items with lowest adherence. Advanced age, duration of surgery, open surgery and diverting stoma were predictive factors of low compliance at multivariate analysis. Overall morbidity and major complications were significantly higher (p < 0.001) in patients with low compliance on POD 2. At multivariate analysis, failure to remove urinary catheter on POD 2 (OR = 1.83) was significantly correlated with postoperative complications. Low compliance to enhanced recovery protocol on POD 2 was significantly associated with morbidity. Failure to remove the urinary catheter was the most predictive indicator. Advanced age, long procedure, open surgery and diverting stoma were independent predictive factors of low compliance.

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Colon/Rectal Cancer Surgery

Hagerty,

Dakwar,

Lee

2023

Anesthesia for Oncological Surgery

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Transversus abdominis plane block for laparoscopic colorectal surgery: A meta-analysis of randomised controlled trials

Cited by 14 publications

References 57 publications

Laparoscopic versus ultrasound‐guided transversus abdominis plane block in colorectal surgery: a non‐inferiority, multicentric randomized double‐blinded clinical trial

Laparoscopic versus ultrasound‐guided transversus abdominis plane block in colorectal surgery: a non‐inferiority, multicentric randomized double‐blinded clinical trial

Early Postoperative Low Compliance to Enhanced Recovery Pathway in Rectal Cancer Patients

Colon/Rectal Cancer Surgery

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