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Background <p>Transversus abdominus plane (TAP) blocks have become increasingly popular, due to a perceived reduction in post-operative pain following laparoscopic surgery. Their value following sleeve gastrectomy remains unclear.</p> Objectives <p>To perform a systematic review and meta-analysis of randomized clinical trials (RCTs) evaluating the efficacy of TAP block in patients undergoing laparoscopic sleeve gastrectomy.</p> Setting <p>Integration of data from bariatric surgery units across the world.</p> Methods <p>A systematic review was performed as per PRISMA guidelines. Meta-analysis was performed using Review Manager v5.4.</p> Results <p>Eleven RCTs including 776 patients were included with 338 randomized to TAP block (50.0%). A non-significant equipoise was observed between groups for mean age, gender, body mass indices, and American Society of Anesthesiologists grades (all <i>P</i> &gt; 0.050). At meta-analyses, patients receiving TAP block had significantly reduced post-operative visual analogue scores (VAS) at 0–60&#xa0;min (mean difference (MD), − 1.23; 95% confidence interval (CI), − 1.87 to − 0.58; <i>P</i> &lt; 0.001), 2&#xa0;h (MD, − 1.78; 95% CI, − 3.28 to − 0.27; <i>P</i> &lt; 0.001), 4&#xa0;h (MD, − 1.00; 95% CI, − 1.24 to − 0.76; <i>P</i> &lt; 0.001), 6&#xa0;h (MD, − 1.58; 95% CI, − 2.46 to − 0.69; <i>P</i> &lt; 0.001), 12&#xa0;h (MD, − 1.13; 95% CI, − 1.80 to − 0.46; <i>P</i> = 0.001), and 24&#xa0;h (MD, − 0.77; 95% CI − 1.42 to − 0.12; <i>P</i> &lt; 0.001) respectively. At meta-analysis, a non-significant difference was observed for breakthrough analgesia consumption, time to rescue analgesia, post-operative nausea and vomiting, time to ambulation, length of stay, and post-operative complications. Patient satisfaction scores were significantly in favour of TAP block (MD, 0.88; 95% CI, 0.49–1.28; <i>P</i> &lt; 0.001).</p> Conclusion <p>TAP block significantly reduced post-operative pain and improved patient satisfaction following sleeve gastrectomy. TAP block should be considered for patients undergoing this procedure, should expertise allow.</p>

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Transversus Abdominus Plane Block for Laparoscopic Sleeve Gastrectomy—A Systematic Review and Meta-analysis of Randomized Clinical Trials

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月18日

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  • Matthew G. Davey,
  • John C. Conneely,
  • Jarlath C. Bolger,
  • William B. Robb,
  • Noel E. Donlon

摘要

Background

Transversus abdominus plane (TAP) blocks have become increasingly popular, due to a perceived reduction in post-operative pain following laparoscopic surgery. Their value following sleeve gastrectomy remains unclear.

Objectives

To perform a systematic review and meta-analysis of randomized clinical trials (RCTs) evaluating the efficacy of TAP block in patients undergoing laparoscopic sleeve gastrectomy.

Setting

Integration of data from bariatric surgery units across the world.

Methods

A systematic review was performed as per PRISMA guidelines. Meta-analysis was performed using Review Manager v5.4.

Results

Eleven RCTs including 776 patients were included with 338 randomized to TAP block (50.0%). A non-significant equipoise was observed between groups for mean age, gender, body mass indices, and American Society of Anesthesiologists grades (all P > 0.050). At meta-analyses, patients receiving TAP block had significantly reduced post-operative visual analogue scores (VAS) at 0–60 min (mean difference (MD), − 1.23; 95% confidence interval (CI), − 1.87 to − 0.58; P < 0.001), 2 h (MD, − 1.78; 95% CI, − 3.28 to − 0.27; P < 0.001), 4 h (MD, − 1.00; 95% CI, − 1.24 to − 0.76; P < 0.001), 6 h (MD, − 1.58; 95% CI, − 2.46 to − 0.69; P < 0.001), 12 h (MD, − 1.13; 95% CI, − 1.80 to − 0.46; P = 0.001), and 24 h (MD, − 0.77; 95% CI − 1.42 to − 0.12; P < 0.001) respectively. At meta-analysis, a non-significant difference was observed for breakthrough analgesia consumption, time to rescue analgesia, post-operative nausea and vomiting, time to ambulation, length of stay, and post-operative complications. Patient satisfaction scores were significantly in favour of TAP block (MD, 0.88; 95% CI, 0.49–1.28; P < 0.001).

Conclusion

TAP block significantly reduced post-operative pain and improved patient satisfaction following sleeve gastrectomy. TAP block should be considered for patients undergoing this procedure, should expertise allow.