Authors: Hain E et al
Colorectal Disease (Jan 2018)
METHOD All comparative studies focusing on TAP-block after laparoscopic colorectal surgery have been systematically identified through the MEDLINE database, reviewed and included. Meta-analysis was performed according to the Mantel-Haenszel method for random effects. Endpoints included postoperative opioid consumption, morbidity, time to first bowel movement and length of hospital stay.
RESULTS A total of 13 studies, including 7 randomized controlled trials, were included, comprising a total of 600 patients who underwent laparoscopic colorectal surgery with TAP-block, compared to 762 patients without TAP-Block. Meta-analysis of these studies showed that TAP-block was associated with a significantly reduced postoperative opioid consumption the first day after surgery (Weighted Mean Difference (WMD): -14.54 [-25.14; -3.94]; p=0.007) and a significantly shorter time to first bowel movement (WMD: -0.53 [-0.61; -0.44]; p<0.001) but failed to show any impact on length of hospital stay (WMD=-0.32 [-0.83;0.20]; p=0.23) although no study considered length of stay as its primary outcome. Finally, TAP-block was not associated with a significant increase of postoperative overall complication rate (OR=0.84 [0.62 – 1.14]; p=0.27).
CONCLUSION TAP-block in laparoscopic colorectal surgery improves postoperative opioid consumption and postoperative digestive function recovery without any significant drawback.