Mária Földi1,2,3, Alexandra Soós1,2,3, Péter Hegyi1,2,4, Szabolcs Kiss1,2,3, Zsolt Szakács1,2, Margit Solymár1,2, Erika Pétervári1,2, Márta Balaskó1,2, Krzysztof Kusza5, Zsolt Molnár6,7,8. 1. Institute for Translational Medicine, Medical School, University of Pécs, 12 Ifjúság St., Pécs, 7624, Hungary. 2. Szentágothai Research Centre, University of Pécs, Pécs, Hungary. 3. Doctoral School of Clinical Medicine, University of Szeged, Szeged, Hungary. 4. Division of Translational Medicine, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary. 5. Department of Anesthesiology and Intensive Therapy, Poznan University for Medical Sciences, Poznan, Poland. 6. Institute for Translational Medicine, Medical School, University of Pécs, 12 Ifjúság St., Pécs, 7624, Hungary. zsoltmolna@gmail.com. 7. Szentágothai Research Centre, University of Pécs, Pécs, Hungary. zsoltmolna@gmail.com. 8. Department of Anesthesiology and Intensive Therapy, Poznan University for Medical Sciences, Poznan, Poland. zsoltmolna@gmail.com.
Abstract
PURPOSE: Pain after bariatric surgery can prolong recovery. This patient group is highly susceptible to opioid-related side effects. Enhanced Recovery After Surgery guidelines strongly recommend the administration of multimodal medications to reduce narcotic consumption. However, the role of ultrasound-guided transversus abdominis plane (USG-TAP) block in multimodal analgesia of weight loss surgeries remains controversial. MATERIALS AND METHODS: A systematic search was performed in four databases for studies published up to September 2019. We considered randomized controlled trials that assessed the efficacy of perioperative USG-TAP block as a part of multimodal analgesia in patients with laparoscopic bariatric surgery. RESULTS: Eight studies (525 patients) were included in the meta-analysis. Pooled analysis showed lower pain scores with USG-TAP block at every evaluated time point and lower opioid requirement in the USG-TAP block group (weighted mean difference (WMD) = - 7.59 mg; 95% CI - 9.86, - 5.39; p < 0.001). Time to ambulate was shorter with USG-TAP block (WMD = - 2.22 h; 95% CI - 3.89, - 0.56; p = 0.009). This intervention also seemed to be safe: only three non-severe complications with USG-TAP block were reported in the included studies. CONCLUSION: Our results may support the incorporation of USG-TAP block into multimodal analgesia regimens of ERAS protocols for bariatric surgery.
PURPOSE:Pain after bariatric surgery can prolong recovery. This patient group is highly susceptible to opioid-related side effects. Enhanced Recovery After Surgery guidelines strongly recommend the administration of multimodal medications to reduce narcotic consumption. However, the role of ultrasound-guided transversus abdominis plane (USG-TAP) block in multimodal analgesia of weight loss surgeries remains controversial. MATERIALS AND METHODS: A systematic search was performed in four databases for studies published up to September 2019. We considered randomized controlled trials that assessed the efficacy of perioperative USG-TAP block as a part of multimodal analgesia in patients with laparoscopic bariatric surgery. RESULTS: Eight studies (525 patients) were included in the meta-analysis. Pooled analysis showed lower pain scores with USG-TAP block at every evaluated time point and lower opioid requirement in the USG-TAP block group (weighted mean difference (WMD) = - 7.59 mg; 95% CI - 9.86, - 5.39; p < 0.001). Time to ambulate was shorter with USG-TAP block (WMD = - 2.22 h; 95% CI - 3.89, - 0.56; p = 0.009). This intervention also seemed to be safe: only three non-severe complications with USG-TAP block were reported in the included studies. CONCLUSION: Our results may support the incorporation of USG-TAP block into multimodal analgesia regimens of ERAS protocols for bariatric surgery.
Entities:
Keywords:
Bariatric surgery; Meta-analysis; Pain; TAP block
Authors: Karen C Nielsen; Ulrich Guller; Susan M Steele; Stephen M Klein; Roy A Greengrass; Ricardo Pietrobon Journal: Anesthesiology Date: 2005-01 Impact factor: 7.892
Authors: Zoka Milan; Dominic Tabor; Patricia McConnell; James Pickering; Mitko Kocarev; Frances du Feu; Sarah Barton Journal: Med Glas (Zenica) Date: 2011-08
Authors: Gildasio S De Oliveira; Paul Fitzgerald; Shireen Ahmad; John Kim; Rohit Rahangdale; Robert McCarthy Journal: World J Gastrointest Surg Date: 2014-02-27
Authors: Christopher L Wu; Adam B King; Timothy M Geiger; Michael C Grant; Michael P W Grocott; Ruchir Gupta; Jennifer M Hah; Timothy E Miller; Andrew D Shaw; Tong J Gan; Julie K M Thacker; Michael G Mythen; Matthew D McEvoy Journal: Anesth Analg Date: 2019-08 Impact factor: 5.108
Authors: Owoicho Adogwa; Aladine A Elsamadicy; Jared Fialkoff; Joseph Cheng; Isaac O Karikari; Carlos Bagley Journal: Spine (Phila Pa 1976) Date: 2017-09-15 Impact factor: 3.468
Authors: Erik Stenberg; Luiz Fernando Dos Reis Falcão; Mary O'Kane; Ronald Liem; Dimitri J Pournaras; Paulina Salminen; Richard D Urman; Anupama Wadhwa; Ulf O Gustafsson; Anders Thorell Journal: World J Surg Date: 2022-01-04 Impact factor: 3.352