title: Clinical safety and effectiveness of transversus abdominis plane (TAP) block in post-operative analgesia: a systematic review and meta-analysis.
abstract: Transversus abdominis plane (TAP) blocks can provide analgesia postoperatively for a range of surgeries. Abundant clinical trials have assessed TAP block showing positive analgesic effects. This systematic review assesses safety and effectiveness outcomes of TAP block in all clinical settings, comparing with both active (standard care) and inactive (placebo) comparators. PubMed, EMBASE, The Cochrane Library and the University of York CRD databases were searched. RCTs were screened for their eligibility and assessed for risk of bias. Meta-analyses were performed on available data. TAP block showed an equivalent safety profile to all comparators in the incidence of nausea (OR = 1.07) and vomiting (OR = 0.81). TAP block was more effective in reducing morphine consumption [MD = 13.05, 95% CI (8.33, 51.23)] and in delaying time to first analgesic request [MD = 123.49, 95% CI (48.59, 198.39)]. Postoperative pain within 24 h was reduced or at least equivalent in TAP block compared to its comparators. Therefore, TAP block is a safe and effective procedure compared to standard care, placebo and other analgesic techniques. Further research is warranted to investigate whether the TAP block technique can be improved by optimizing dose and technique-related factors.
authors.affiliation: Australian Safety and Efficacy Register of New Interventional Procedures, Surgical (ASERNIP-S), Royal Australasian College of Surgeons, 199 Ward Street, North Adelaide, SA, 5006, Australia. college.asernip@surgeons.org.
authors.forename: Ning
authors.identifier: http://orcid.org/0000-0002-3191-8688
authors.initials: N
authors.lastname: Ma
authors.affiliation: Australian Safety and Efficacy Register of New Interventional Procedures, Surgical (ASERNIP-S), Royal Australasian College of Surgeons, 199 Ward Street, North Adelaide, SA, 5006, Australia.
authors.forename: Joanna K
authors.initials: JK
authors.lastname: Duncan
authors.affiliation: Australian Safety and Efficacy Register of New Interventional Procedures, Surgical (ASERNIP-S), Royal Australasian College of Surgeons, 199 Ward Street, North Adelaide, SA, 5006, Australia.
authors.forename: Anje J
authors.initials: AJ
authors.lastname: Scarfe
authors.affiliation: KAGes, Styrian Hospitals Holding, Graz, Austria.
authors.forename: Susanne
authors.initials: S
authors.lastname: Schuhmann
authors.affiliation: Australian Safety and Efficacy Register of New Interventional Procedures, Surgical (ASERNIP-S), Royal Australasian College of Surgeons, 199 Ward Street, North Adelaide, SA, 5006, Australia.
authors.forename: Alun L
authors.initials: AL
authors.lastname: Cameron
mesh_terms: D000009:Abdominal Muscles; D000698:Analgesia / Q000379:methods*; D000701:Analgesics, Opioid / Q000008:administration & dosage; D006801:Humans; D009020:Morphine / Q000008:administration & dosage; D009407:Nerve Block / Q000379:methods*; D010149:Postoperative Pain / Q000188:drug therapy*
chemical_list: D000701:Analgesics, Opioid; D009020:Morphine
keywords: Meta-analysis; Nerve block; Postoperative analgesia; Transversus abdominis plane