Clinical effectiveness of transversus abdominis plane (TAP) blocks for pain relief after caesarean section: a meta-analysis

Research output: Contribution to journalArticle

Authors

Colleges, School and Institutes

External organisations

  • University of Sheffield

Abstract

Background

The effectiveness of transversus abdominis plane (TAP) blocks for acute pain relief after caesarean section, in comparison to normal practice, remains uncertain.

Methods

Electronic literature databases were searched from inception to May 2016 for randomised controlled trials that assessed the effectiveness of TAP blocks following caesarean section. Trials were eligible if comparisons were made against no block or placebo, and/or intrathecal morphine. Risk of bias was assessed using the Cochrane tool. Data for consistent outcomes were subject, where possible, to meta-analysis and presented as either mean differences with 95% confidence intervals or incidence of a particular event.

Results

Twenty published studies fulfilled our inclusion criteria. TAP blocks significantly reduced pain at rest both when compared with placebo or no TAP blocks (−0.96, 95% CI −1.67 to −0.25, P=0.008) and intrathecal morphine (1.10, 95% CI 0.59 to 1.60, P<0.0001). Both these comparisons showed the greatest improvement with pain on movement, (−1.58, 95% CI −2.69 to −0.47, P=0.005 and 1.35, 95% CI 0.76 to 1.94, respectively,P<0.00001). Morphine consumption was significantly reduced with TAP blocks when compared to placebo or no TAP blocks (−15.88, 95% CI −22.02 to −9.73, P<0.00001). This significance was lost when TAP blocks were both compared to intrathecal morphine (0.89, 95% CI −0.64 to 2.43, P=0.25) and given in co-administration (0.00, 95% CI −0.10 to 0.10, P=1.00).

Conclusion

TAP blocks provide effective analgesia after caesarean section; however, additional benefits are more difficult to demonstrate when long-acting intrathecal opioids are administered.

Details

Original languageEnglish
Pages (from-to)45-60
JournalInternational Journal of Obstetric Anesthesia
Volume28
Early online date5 Aug 2016
Publication statusPublished - Dec 2016

Keywords

  • Transversus abdominis plane block, TAP block, Caesarean section