Postoperative Analgesia by a Transversus Abdominis Plane Block Using Different Concentrations of Ropivacaine for Abdominal Surgery: A Meta-Analysis
Transversus abdominis plane block (TAPB) has been proven to be an effective means of postoperative anesthesia, but the optimum effective concentration of ropivacaine warrants further research. This study aimed to identify the optimal ropivacaine concentration of TAPB using a meta-analysis. This stud...
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| Veröffentlicht in: | The Clinical journal of pain 2017-09, Vol.33 (9), p.853-863 |
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| container_title | The Clinical journal of pain |
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| creator | Sun, Ni Wang, Shouyong Ma, Pengpeng Liu, Shuting Shao, Aijie Xiong, Ling |
| description | Transversus abdominis plane block (TAPB) has been proven to be an effective means of postoperative anesthesia, but the optimum effective concentration of ropivacaine warrants further research.
This study aimed to identify the optimal ropivacaine concentration of TAPB using a meta-analysis.
This study consisted of a meta-analysis of randomized controlled trials (RCTs). We searched online databases, including PubMed, Embase, the Cochrane Database of Systematic Reviews, and Web of Science. RCTs investigating the 24-hour postoperative opioid consumption and the rest and dynamic pain scores 2, 12, and 24 hours after surgery were included in this analysis. We also assessed opioid-related side-effects and patient satisfaction 24 hours after surgery.
Nineteen RCTs (1217 patients) were included in this meta-analysis, which showed that only TAPB with 0.375% and 0.5% ropivacaine was able to reduce opioid consumption 24 hours after surgery by weighted mean differences of -6.55 and -4.44 mg (morphine IV equivalents), respectively (P |
| doi_str_mv | 10.1097/AJP.0000000000000468 |
| format | Article |
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This study aimed to identify the optimal ropivacaine concentration of TAPB using a meta-analysis.
This study consisted of a meta-analysis of randomized controlled trials (RCTs). We searched online databases, including PubMed, Embase, the Cochrane Database of Systematic Reviews, and Web of Science. RCTs investigating the 24-hour postoperative opioid consumption and the rest and dynamic pain scores 2, 12, and 24 hours after surgery were included in this analysis. We also assessed opioid-related side-effects and patient satisfaction 24 hours after surgery.
Nineteen RCTs (1217 patients) were included in this meta-analysis, which showed that only TAPB with 0.375% and 0.5% ropivacaine was able to reduce opioid consumption 24 hours after surgery by weighted mean differences of -6.55 and -4.44 mg (morphine IV equivalents), respectively (P<0.05). A meta-regression analysis did not reveal an association between the local anesthetic dose (in mg), surgery, anesthesia, block timing, and the TAPB effect on opioid consumption. Ropivacaine concentrations of 0.375% and 0.5% reduced the 2-hour postoperative pain score and reduced the incidence of nausea and vomiting, but this analgesic effect disappeared at 12 and 24 hours. Only TAPB with 0.375% ropivacaine improved the degree of satisfaction 24 hours after surgery (weighted mean difference of 0.87 [0.08-1.66], P=0.03).
In terms of efficacy and safety, the use of 0.375% ropivacaine for TAPB is preferred in the clinical work.</description><identifier>ISSN: 0749-8047</identifier><identifier>EISSN: 1536-5409</identifier><identifier>DOI: 10.1097/AJP.0000000000000468</identifier><identifier>PMID: 28002093</identifier><language>eng</language><publisher>United States</publisher><subject>Abdomen - surgery ; Abdominal Muscles - drug effects ; Abdominal Muscles - innervation ; Abdominal Muscles - surgery ; Amides - administration & dosage ; Amides - adverse effects ; Anesthetics, Local - administration & dosage ; Anesthetics, Local - adverse effects ; Humans ; Nerve Block ; Pain, Postoperative - drug therapy ; Randomized Controlled Trials as Topic</subject><ispartof>The Clinical journal of pain, 2017-09, Vol.33 (9), p.853-863</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c256t-cdd6b6abbc9865bc160b630849a9d6680a48256a176100f0e0169b7733fe020d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28002093$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sun, Ni</creatorcontrib><creatorcontrib>Wang, Shouyong</creatorcontrib><creatorcontrib>Ma, Pengpeng</creatorcontrib><creatorcontrib>Liu, Shuting</creatorcontrib><creatorcontrib>Shao, Aijie</creatorcontrib><creatorcontrib>Xiong, Ling</creatorcontrib><title>Postoperative Analgesia by a Transversus Abdominis Plane Block Using Different Concentrations of Ropivacaine for Abdominal Surgery: A Meta-Analysis</title><title>The Clinical journal of pain</title><addtitle>Clin J Pain</addtitle><description>Transversus abdominis plane block (TAPB) has been proven to be an effective means of postoperative anesthesia, but the optimum effective concentration of ropivacaine warrants further research.
This study aimed to identify the optimal ropivacaine concentration of TAPB using a meta-analysis.
This study consisted of a meta-analysis of randomized controlled trials (RCTs). We searched online databases, including PubMed, Embase, the Cochrane Database of Systematic Reviews, and Web of Science. RCTs investigating the 24-hour postoperative opioid consumption and the rest and dynamic pain scores 2, 12, and 24 hours after surgery were included in this analysis. We also assessed opioid-related side-effects and patient satisfaction 24 hours after surgery.
Nineteen RCTs (1217 patients) were included in this meta-analysis, which showed that only TAPB with 0.375% and 0.5% ropivacaine was able to reduce opioid consumption 24 hours after surgery by weighted mean differences of -6.55 and -4.44 mg (morphine IV equivalents), respectively (P<0.05). A meta-regression analysis did not reveal an association between the local anesthetic dose (in mg), surgery, anesthesia, block timing, and the TAPB effect on opioid consumption. Ropivacaine concentrations of 0.375% and 0.5% reduced the 2-hour postoperative pain score and reduced the incidence of nausea and vomiting, but this analgesic effect disappeared at 12 and 24 hours. Only TAPB with 0.375% ropivacaine improved the degree of satisfaction 24 hours after surgery (weighted mean difference of 0.87 [0.08-1.66], P=0.03).
In terms of efficacy and safety, the use of 0.375% ropivacaine for TAPB is preferred in the clinical work.</description><subject>Abdomen - surgery</subject><subject>Abdominal Muscles - drug effects</subject><subject>Abdominal Muscles - innervation</subject><subject>Abdominal Muscles - surgery</subject><subject>Amides - administration & dosage</subject><subject>Amides - adverse effects</subject><subject>Anesthetics, Local - administration & dosage</subject><subject>Anesthetics, Local - adverse effects</subject><subject>Humans</subject><subject>Nerve Block</subject><subject>Pain, Postoperative - drug therapy</subject><subject>Randomized Controlled Trials as Topic</subject><issn>0749-8047</issn><issn>1536-5409</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdUctOwzAQtBCIlsIfIOQjl5R1kzgJt1DeAlFBe45sx6kMaVy8SaV-Bz-MqxaE2MPuZR6aHUJOGQwZZMlF_jgZwt-JeLpH-iwOeRBHkO2TPiRRFqQQJT1yhPgOwOJRCoek5zeMIAv75GtisbVL7URrVprmjajnGo2gck0FnTrR4Eo77JDmsrQL0xikk1o0ml7VVn3QGZpmTq9NVWmnm5aObaP83cjZBqmt6KtdmpVQwnhOZd2PjqjpW-fm2q0vaU6fdSuCjfkaDR6Tg0rUqE92d0BmtzfT8X3w9HL3MM6fAjWKeRuosuSSCylVlvJYKsZB8hDSKBNZyXkKIko9ULCEM4AKNDCeySQJw0r79GU4IOdb3aWzn53GtlgYVLrexLMdFiyNPWPEATw02kKVs4hOV8XSmYVw64JBsamj8HUU_-vwtLOdQycXuvwl_fw__AaMgobf</recordid><startdate>20170901</startdate><enddate>20170901</enddate><creator>Sun, Ni</creator><creator>Wang, Shouyong</creator><creator>Ma, Pengpeng</creator><creator>Liu, Shuting</creator><creator>Shao, Aijie</creator><creator>Xiong, Ling</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20170901</creationdate><title>Postoperative Analgesia by a Transversus Abdominis Plane Block Using Different Concentrations of Ropivacaine for Abdominal Surgery: A Meta-Analysis</title><author>Sun, Ni ; Wang, Shouyong ; Ma, Pengpeng ; Liu, Shuting ; Shao, Aijie ; Xiong, Ling</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c256t-cdd6b6abbc9865bc160b630849a9d6680a48256a176100f0e0169b7733fe020d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Abdomen - surgery</topic><topic>Abdominal Muscles - drug effects</topic><topic>Abdominal Muscles - innervation</topic><topic>Abdominal Muscles - surgery</topic><topic>Amides - administration & dosage</topic><topic>Amides - adverse effects</topic><topic>Anesthetics, Local - administration & dosage</topic><topic>Anesthetics, Local - adverse effects</topic><topic>Humans</topic><topic>Nerve Block</topic><topic>Pain, Postoperative - drug therapy</topic><topic>Randomized Controlled Trials as Topic</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sun, Ni</creatorcontrib><creatorcontrib>Wang, Shouyong</creatorcontrib><creatorcontrib>Ma, Pengpeng</creatorcontrib><creatorcontrib>Liu, Shuting</creatorcontrib><creatorcontrib>Shao, Aijie</creatorcontrib><creatorcontrib>Xiong, Ling</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Clinical journal of pain</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sun, Ni</au><au>Wang, Shouyong</au><au>Ma, Pengpeng</au><au>Liu, Shuting</au><au>Shao, Aijie</au><au>Xiong, Ling</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Postoperative Analgesia by a Transversus Abdominis Plane Block Using Different Concentrations of Ropivacaine for Abdominal Surgery: A Meta-Analysis</atitle><jtitle>The Clinical journal of pain</jtitle><addtitle>Clin J Pain</addtitle><date>2017-09-01</date><risdate>2017</risdate><volume>33</volume><issue>9</issue><spage>853</spage><epage>863</epage><pages>853-863</pages><issn>0749-8047</issn><eissn>1536-5409</eissn><abstract>Transversus abdominis plane block (TAPB) has been proven to be an effective means of postoperative anesthesia, but the optimum effective concentration of ropivacaine warrants further research.
This study aimed to identify the optimal ropivacaine concentration of TAPB using a meta-analysis.
This study consisted of a meta-analysis of randomized controlled trials (RCTs). We searched online databases, including PubMed, Embase, the Cochrane Database of Systematic Reviews, and Web of Science. RCTs investigating the 24-hour postoperative opioid consumption and the rest and dynamic pain scores 2, 12, and 24 hours after surgery were included in this analysis. We also assessed opioid-related side-effects and patient satisfaction 24 hours after surgery.
Nineteen RCTs (1217 patients) were included in this meta-analysis, which showed that only TAPB with 0.375% and 0.5% ropivacaine was able to reduce opioid consumption 24 hours after surgery by weighted mean differences of -6.55 and -4.44 mg (morphine IV equivalents), respectively (P<0.05). A meta-regression analysis did not reveal an association between the local anesthetic dose (in mg), surgery, anesthesia, block timing, and the TAPB effect on opioid consumption. Ropivacaine concentrations of 0.375% and 0.5% reduced the 2-hour postoperative pain score and reduced the incidence of nausea and vomiting, but this analgesic effect disappeared at 12 and 24 hours. Only TAPB with 0.375% ropivacaine improved the degree of satisfaction 24 hours after surgery (weighted mean difference of 0.87 [0.08-1.66], P=0.03).
In terms of efficacy and safety, the use of 0.375% ropivacaine for TAPB is preferred in the clinical work.</abstract><cop>United States</cop><pmid>28002093</pmid><doi>10.1097/AJP.0000000000000468</doi><tpages>11</tpages></addata></record> |
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| subjects | Abdomen - surgery Abdominal Muscles - drug effects Abdominal Muscles - innervation Abdominal Muscles - surgery Amides - administration & dosage Amides - adverse effects Anesthetics, Local - administration & dosage Anesthetics, Local - adverse effects Humans Nerve Block Pain, Postoperative - drug therapy Randomized Controlled Trials as Topic |
| title | Postoperative Analgesia by a Transversus Abdominis Plane Block Using Different Concentrations of Ropivacaine for Abdominal Surgery: A Meta-Analysis |
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