title: Transversus abdominis plane block versus local anaesthetic wound infiltration for postoperative analgesia: A systematic review and meta-analysis.
abstract: BACKGROUND
  Transversus abdominis plane (TAP) block and local anaesthetic wound infiltration can provide effective pain relief at the wound site after surgery. However, the relative efficacy of two techniques for postoperative analgesia remains controversial.
  
  
  METHODS
  We searched PUBMED, EMBASE and CENTRAL databases for randomized controlled trials (RCTs) comparing TAP block with wound infiltration for pain relief after surgery. The primary outcomes were pain scores at rest and on movement at 1, 8 and 24 hours postoperatively and cumulative morphine consumption over 24 hours. The secondary outcomes were time to first rescue analgesic, number of rescue analgesic use and opioids-related side-effects.
  
  
  RESULTS
  Nine RCTs with a total of 500 participants were included. TAP block was associated with significant lower rest and dynamic pain scores at 8 hour [MD = -1.08, 95% CI (-1.89-0.26), P = 0.009] and 24 hour [MD = -0.83, 95% CI (-1.60, -0.06), P = 0.03] postoperatively than wound infiltration, but no significant difference was found at 1 hour [MD = -0.94, 95% CI (-1.97, 0.09), P = 0.08] postoperatively. In adults, TAP block significantly reduced 24-hour overall morphine consumption by 3.85 mg [MD = -3.85, 95% CI (-7.47, -0.22), P = 0.04] compared with wound infiltration. Subgroup analysis showed that adults received TAP block appeared to have lower rest pain scores at 24 hour than children (P = 0.008).
  
  
  CONCLUSIONS
  TAP block provides superior analgesia compared with wound infiltration in the setting of a multimodal analgesic regimen. Subgroup analysis indicated that adults may have benefits additional to the analgesic effect than children.
authors.affiliation: Department Anesthesiology, Cangzhou City Central Hospital No. 16, Xinhua West Road, Canal Zone, Cangzhou 061001, Hebei Province, China.
authors.forename: Qingduo
authors.initials: Q
authors.lastname: Guo
authors.affiliation: Department Anesthesiology, Cangzhou City Central Hospital No. 16, Xinhua West Road, Canal Zone, Cangzhou 061001, Hebei Province, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Li
authors.affiliation: Department Anesthesiology, Cangzhou City Central Hospital No. 16, Xinhua West Road, Canal Zone, Cangzhou 061001, Hebei Province, China.
authors.forename: Lixian
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department Anesthesiology, Cangzhou City Central Hospital No. 16, Xinhua West Road, Canal Zone, Cangzhou 061001, Hebei Province, China.
authors.forename: Dong
authors.initials: D
authors.lastname: Zhang
authors.affiliation: Department Anesthesiology, Cangzhou City Central Hospital No. 16, Xinhua West Road, Canal Zone, Cangzhou 061001, Hebei Province, China.
authors.forename: Yali
authors.initials: Y
authors.lastname: Ma
keywords: Acute pain; TAP block; anaesthetic techniques; regional blockade; regional pain