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Transversus abdominis plane block versus wound infiltration for post‐cesarean section analgesia: A systematic review and meta‐analysis of randomized controlled trials
Author(s) -
Riemma Gaetano,
Schiattarella Antonio,
Cianci Stefano,
La Verde Marco,
Morlando Maddalena,
Sisti Giovanni,
Esposito Irene,
Della Corte Luigi,
Sansone Pasquale,
De Franciscis Pasquale
Publication year - 2021
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.13563
Subject(s) - medicine , randomized controlled trial , relative risk , confidence interval , anesthesia , cochrane library , adverse effect , meta analysis , analgesic , sedation , opioid , surgery , receptor
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.