• Br J Anaesth · Nov 2012

    Review Meta Analysis

    Transversus abdominis plane block for postoperative analgesia after Caesarean delivery performed under spinal anaesthesia? A systematic review and meta-analysis.

    TAP block reduces pain severity, morphine consumption and opioid side effects after caesarean section when intrathecal morphine is not used.

    pearl
    • F W Abdallah, S H Halpern, and C B Margarido.
    • Division of Obstetrical Anesthesia, Department of Anesthesia, Obstetrical Anesthesia Research Unit, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
    • Br J Anaesth. 2012 Nov 1;109(5):679-87.

    AbstractThe transversus abdominis plane (TAP) block is a field block that provides postoperative analgesia for abdominal surgery. Its analgesic utility after Caesarean delivery (CD) remains controversial. This systematic review and meta-analysis examines whether TAP block can reduce i.v. morphine consumption in the first 24 h after CD. The authors retrieved randomized controlled trials comparing TAP block with placebo in CD. Postoperative i.v. morphine consumption during the first 24 h was selected as a primary outcome. Pain scores and both maternal and neonatal opioid-related side-effects were secondary outcomes. Where possible, meta-analytic techniques and random effects modelling were used to combine data. Trials were stratified based on whether or not spinal morphine was used as part of the analgesic regimen. Five trials including 312 patients were identified. TAP block reduced the mean 24 h i.v. morphine consumption by 24 mg [95% confidence interval (CI) -39.65 to -7.78] when spinal morphine was not used. TAP block also reduced visual analogue scale pain scores (10 cm line where 0 cm, no pain, and 10 cm, worst pain) by 0.8 cm (95% CI -1.53 to -0.05, P=0.01), and decreased the incidence of opioid-related side-effects. The differences in primary and secondary outcomes were not significant when spinal morphine was used. TAP block provides superior analgesia compared with placebo and can reduce the first 24 h morphine consumption in the setting of a multimodal analgesic regimen that excludes spinal morphine. TAP block can provide effective analgesia when spinal morphine is contraindicated or not used.

      Pubmed     Free full text   Copy Citation     Plaintext  

      Add institutional full text...

    This article appears in the collections: Regional stuff and Meta-analyses.

    Notes

    pearl
    1

    TAP block reduces pain severity, morphine consumption and opioid side effects after caesarean section when intrathecal morphine is not used.

    Daniel Jolley  Daniel Jolley
     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…