Use of Transversus Abdominis Plane Block in Cosmetic Abdominoplasties: A Systematic Review of the Literature

Transversus abdominis plane (TAP) block is used in abdominoplasties for postoperative pain control. There has been no systematic review and meta-analysis of its use reported in the literature. The authors performed a systematic review that focused on the use of TAP block in abdominoplasties. EMBASE, Cochrane Library, Ovid Medicine, MEDLINE, Google Scholar, and PubMed databases were searched from its inception to April 2019. Peer-reviewed articles published in the English language were included. The efficacy of TAP block was determined from a review of the reported studies. The authors’ search retrieved 30 unique articles. Two independent reviewers screened texts, selecting 6 articles for inclusion. Of the included studies, 3 were randomized controlled studies, 1 was a prospective controlled study, 1 was a retrospective cohort study, and 1 was a prospective nonrandomized uncontrolled study. The level of evidence of included studies ranges from level II to level III. There were no level I studies. All of the studies concluded that TAP block was more effective in controlling pain and decreasing narcotic use compared with controls. There was significant heterogeneity in the method of administration, compositions, and dosage of the TAP block. The TAP block provides effective analgesia after abdominoplasty and reduces the use of opioids. However, its effectiveness seems to be limited to the first few postoperative hours. More studies are needed to evaluate for the optimum dosing and mode of delivery of the anesthetic.