The analgesic efficacy of transverse abdominis plane block versus epidural analgesia: A systematic review with meta-analysis
| Autor: | Moira Baeriswyl, Eric Albrecht, Kyle R. Kirkham, Denis Piubellini, Frank Zeiter |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Pain score
education.field_of_study business.industry Analgesic Population Block (permutation group theory) General Medicine Confidence interval 03 medical and health sciences 0302 clinical medicine 030202 anesthesiology Meta-analysis Relative risk Anesthesia Medicine 030212 general & internal medicine Abdominal Muscles Adult Analgesia Epidural/adverse effects Analgesia Epidural/methods Child Child Preschool Humans Hypotension/epidemiology Hypotension/etiology Infant Length of Stay/statistics & numerical data Nerve Block/adverse effects Nerve Block/methods Pain Measurement Pain Postoperative/therapy Treatment Outcome education business Abdominal surgery |
| Zdroj: | Medicine, vol. 97, no. 26, pp. e11261 |
| Popis: | BACKGROUND The aim of the study was to compare the analgesic efficacy of epidural analgesia and transverse abdominis plane (TAP) block. TAP block has gained popularity to provide postoperative analgesia after abdominal surgery but its advantage over epidural analgesia is disputed. METHODS We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines. Only trials comparing TAP block with epidural analgesia were included. The primary outcome was pain score at rest (analog scale, 0-10) on postoperative day 1 analyzed in subgroups according to the population (children and adults). Secondary outcomes included rate of hypotension, length of stay, and functional outcomes (time to first bowel sound, time to first flatus). RESULTS Ten controlled trials, including 505 patients (195 children and 310 adults), were identified. Pain scores at rest on postoperative day 1 were equivalent for TAP block and epidural analgesia groups in children (mean difference: 0.3; 95% confidence interval [CI]: -0.1 to 0.6; I = 0%; P = .15) and in adults (mean difference: 0.5; 95% CI: -0.1 to 1.0; I = 81%; P = .10). The quality of evidence for our primary outcome was moderate according to the GRADE system. The epidural analgesia group experienced a higher rate of hypotension (relative risk: 0.13; 95% CI: 0.04-0.38; I = 0%; P = .0002), while hospital length of stay was shorter in the TAP block group (mean difference: -0.6 days; 95% CI: -0.9 to -0.3 days; I = 0%; P |
| Databáze: | OpenAIRE |
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