Department of Anesthesiology, Jiangnan University Medical Center, Affiliated Wuxi Clinical College of Nantong University, Wuxi, 214002, China.
Department of Anesthesiology, Affiliated Hospital of Nanjing, University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, 210000, China.
BMC Anesthesiol. 2024 Mar 1;24(1):87. doi: 10.1186/s12871-024-02469-x.
Postoperative nausea and vomiting (PONV) is a common postoperative complication, and Transversus abdominis plane (TAP) block can provide effective analgesia for surgical operation. However, but there is not enough evidence to prove its advantage for nausea and vomiting. The objective of this meta-analysis was to evaluate the efficacy of TAP block on PONV.
Two independent researchers conducted searches for randomized controlled trials (RCTs) in PubMed, Embase, and Cochrane Central Register of Controlled Trials. We used Review Manager software for meta-analysis.
In this meta-analysis, twenty-six trials with 1981 patients were examined. The results showed that TAP block reduced postoperative nausea (Risk Difference (RD) = -0.10, 95% confidence interval (CI): -0.15 to -0.05) compared with no TAP block. TAP block reduced the dose of fentanyl (Standardized Mean Difference (SMD) = -1.17, 95% CI: -2.07 to -0.26) and morphine (SMD = -1.12, 95% CI: -2.10 to -0.13) compared with no TAP block, when the timing of administration was before surgery (RD = -0.13, 95% CI: -0.19 to -0.07). TAP block reduced postoperative nausea when the ropivacaine dosage is ≤ 100 mg (RD = -0.13, 95% CI: -0.21 to -0.06), bupivacaine dosage ≥ 100 mg ( RD = -0.08, 95% CI: -0.13 to -0.03), and when the ropivacaine concentration was ≤ 0.375% (RD = -0.11, 95% CI: -0.18 to -0.04). TAP block significantly reduced the incidence of nausea when the types of opioid drugs in PCA is tramadol (RD = -0.13, 95% CI: -0.24 to -0.03). TAP block could reduce the VAS (SMD= -0.99, 95% CI: -1.29 to -0.70) and reduce the time of extubation (SMD = -0.71, 95% CI: -1.34 to -0.08).
The meta-analysis conducted in this study revealed that TAP block could reduce the incidence of PONV, and the efficacy of TAP block may be influenced by factors such as administration time, local anesthetic dosage and concentration, types of opioid drugs in PCA.
术后恶心呕吐（PONV）是一种常见的术后并发症，腹横肌平面（TAP）阻滞可提供手术有效的镇痛效果。然而，目前尚无足够的证据证明其在止吐方面的优势。本荟萃分析的目的是评估 TAP 阻滞对 PONV 的疗效。
两名独立研究员在 PubMed、Embase 和 Cochrane 对照试验中心注册库中检索了随机对照试验（RCT）。我们使用 Review Manager 软件进行荟萃分析。
在本荟萃分析中，共纳入了 26 项研究，涉及 1981 例患者。结果表明，与无 TAP 阻滞相比，TAP 阻滞可减少术后恶心（风险差（RD）=-0.10，95%置信区间（CI）：-0.15 至-0.05）。TAP 阻滞可减少芬太尼（标准化均数差（SMD）=-1.17，95%CI：-2.07 至-0.26）和吗啡（SMD=-1.12，95%CI：-2.10 至-0.13）的用量，与无 TAP 阻滞相比，当给药时间在手术前（RD=-0.13，95%CI：-0.19 至-0.07）。当罗哌卡因剂量≤100mg（RD=-0.13，95%CI：-0.21 至-0.06）、布比卡因剂量≥100mg（RD=-0.08，95%CI：-0.13 至-0.03）或罗哌卡因浓度≤0.375%（RD=-0.11，95%CI：-0.18 至-0.04）时，TAP 阻滞可减少术后恶心。当 PCA 中的阿片类药物为曲马多时，TAP 阻滞可显著降低恶心发生率（RD=-0.13，95%CI：-0.24 至-0.03）。TAP 阻滞可降低 VAS（SMD=-0.99，95%CI：-1.29 至-0.70）和拔管时间（SMD=-0.71，95%CI：-1.34 至-0.08）。
本研究进行的荟萃分析显示，TAP 阻滞可降低 PONV 的发生率，TAP 阻滞的疗效可能受到给药时间、局部麻醉药剂量和浓度、PCA 中阿片类药物类型等因素的影响。
