Gaetano Riemma1, Antonio Schiattarella1, Stefano Cianci1, Marco La Verde1, Maddalena Morlando1, Giovanni Sisti2, Irene Esposito3, Luigi Della Corte4, Pasquale Sansone3, Pasquale De Franciscis1. 1. Obstetrics and Gynecology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy. 2. Lincoln Medical and Mental Health Center, Bronx, NY, USA. 3. Anesthesiology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy. 4. Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy.
Abstract
BACKGROUND: Transversus abdominis plane (TAP) block and wound infiltration (WI) with local anesthetics are used for postoperative analgesia after cesarean section (CS), reducing the need for administration of opioids. OBJECTIVE: To compare the analgesic effect of TAP block related to WI. SEARCH STRATEGY: MEDLINE, Scopus, ClinicalTrials.gov, EMBASE, Cochrane Library, and CINAHL were searched from inception until April 2020. SELECTION CRITERIA: Randomized controlled trials (RCTs) about women who underwent TAP block or WI after CS. DATA COLLECTION AND ANALYSIS: Relevant data were extracted and tabulated. Review Manager 5.3 was used for data analysis. Primary outcome was cumulative opioid consumption (COC) 24 and 48 h after CS. MAIN RESULTS: Five RCTs, enrolling 268 women, were included. There were no significant differences between the interventions regarding COC at 24 (mean difference [MD] -1.68, 95% confidence interval [CI] -6.29 to 2.93) and 48 hours (MD 1.28, 95% CI -10.44 to 13.00). Adverse effects (relative risk [RR] 0.93, 95% CI 0.75-1.16), gastrointestinal reactions (RR 1.30, 95% CI 0.46-3.68), or mild-moderate sedation (RR 1.12, 95% CI 0.72-1.74), pain scores, satisfaction of women, and withdrawals were similar between groups. CONCLUSIONS: There might be no significant advantages selecting TAP block over WI for post-CS analgesia.
BACKGROUND: Transversus abdominis plane (TAP) block and wound infiltration (WI) with local anesthetics are used for postoperative analgesia after cesarean section (CS), reducing the need for administration of opioids. OBJECTIVE: To compare the analgesic effect of TAP block related to WI. SEARCH STRATEGY: MEDLINE, Scopus, ClinicalTrials.gov, EMBASE, Cochrane Library, and CINAHL were searched from inception until April 2020. SELECTION CRITERIA: Randomized controlled trials (RCTs) about women who underwent TAP block or WI after CS. DATA COLLECTION AND ANALYSIS: Relevant data were extracted and tabulated. Review Manager 5.3 was used for data analysis. Primary outcome was cumulative opioid consumption (COC) 24 and 48 h after CS. MAIN RESULTS: Five RCTs, enrolling 268 women, were included. There were no significant differences between the interventions regarding COC at 24 (mean difference [MD] -1.68, 95% confidence interval [CI] -6.29 to 2.93) and 48 hours (MD 1.28, 95% CI -10.44 to 13.00). Adverse effects (relative risk [RR] 0.93, 95% CI 0.75-1.16), gastrointestinal reactions (RR 1.30, 95% CI 0.46-3.68), or mild-moderate sedation (RR 1.12, 95% CI 0.72-1.74), pain scores, satisfaction of women, and withdrawals were similar between groups. CONCLUSIONS: There might be no significant advantages selecting TAP block over WI for post-CS analgesia.
Authors: Marco La Verde; Adriano Palmisano; Irene Iavarone; Carlo Ronsini; Domenico Labriola; Stefano Cianci; Ferdinando Schettino; Alfonso Reginelli; Gaetano Riemma; Pasquale De Franciscis Journal: Int J Environ Res Public Health Date: 2022-04-12 Impact factor: 4.614
Authors: Marco La Verde; Pasquale De Franciscis; Clelia Torre; Angela Celardo; Giulia Grassini; Rossella Papa; Stefano Cianci; Carlo Capristo; Maddalena Morlando; Gaetano Riemma Journal: Int J Environ Res Public Health Date: 2022-05-09 Impact factor: 4.614
Authors: Luigi Della Corte; Antonio Mercorio; Mario Palumbo; Francesco Viciglione; Valeria Cafasso; Agostino Candice; Giuseppe Bifulco; Pierluigi Giampaolino Journal: Arch Gynecol Obstet Date: 2022-08-05 Impact factor: 2.493