Use of Transversus Abdominis Plane Block in Hysterectomy: A Systematic Review.

PURPOSE

To examine the effectiveness of transversus abdominis plane (TAP) block in hysterectomy.

DESIGN

Systematic review METHODS: This review followed the guidelines of the PRISMA statement. PubMed, CINAHL, the Cochrane Collaboration, Google Scholar, and other gray literature databases were searched for eligible studies. The evidence level and quality ratings were assessed using the guidelines proposed by the Johns Hopkins Nursing Evidence-Based Practice Model.

FINDINGS

Six randomized controlled trials and three systematic reviews with meta-analysis consisting of 2,164 patients were analyzed. The use of TAP block reduced the pain scores in the early part of the postoperative period with diminishing effect late in the postoperative phase. In addition, TAP block lowered the overall opioid consumption, reduced the incidence of PONV, and prolonged the time for rescue medication. All studies included in the review were categorized as Level I and rated Grade A implying strong confidence in the true effects of TAP block in all outcome measures in the review.

CONCLUSIONS

The addition of TAP block for pain control in hysterectomy patients can improve postoperative pain management. This review found that TAP block has opioid-sparing effects and is safe and effective in reducing pain scores postoperatively in hysterectomy patients.