Transverses Abdominis Plane Block In Postoperative Analgesia After Laparoscopic Cholecystectomy:A Meta-analysis

Objective:To evaluate the efficacy and safety of transabdominis plane block(TAP)in postoperative analgesia after laparoscopic cholecystectomy(LC)and investigate the application that transabdominis plane block in the enhanced recovery after surgery of laparoscopic cholecystectomy..Methods:Five databases(PubMed,Embase,Cochrame Library,CNKI and the CBM,)were comprehensively searched(publication dates ranging from library to 2018)with controlled clinical trial(RCT)or controlled clinical trials(CCT)that compared the efficacy and safety of transabdominis plane block(TAP)in postoperative analgesia after laparoscopic cholecystectomy(LC).The database of articles were placed into the NoteExpress software management,and all articles were strictly included according to the inclusion criteria and exclusion criteria.Each database was screened for quality assessment,data were extracted,and the collected data was analyzed by the Review Manager 5.3 software Results:1.The baseline characteristics of the selected studies:Nine observational studies,eight in English and one in Chinese,with a total of 452 patients(226 in TAP groups and 226 in control groups)were identified in our study.2.The Pain intensity score at 6 hours of rest in two groups:Compared to the control group,the TAP group had a lower pain intensity score at 6 hours.(SMD =-1.09,95% CI:-1.90--0.28 P=0.008).3.The Pain intensity score at 24 hours of rest in two groups: Compared to the control group,the TAP group had a lower pain intensity score at 24 hours of rest.(SMD=-0.91,95% CI:-1.53 to-0.29 P=0.004).4.The Pain intensity score at 6 hours of moving in two groups: Compared to the control group,the TAP group had a lower pain intensity score at 6 hours of moving.(SMD=-1.52,95% CI:-2.55 to-0.49;P=0.004).5.The Pain intensity score at 24 hours of moving in two groups: Compared to the control group,the TAP group had a lower pain intensity score at 24 hours of moving.(SMD =-0.64,95% CI:-1.13--0.14;P = 0.01).6.The Postoperative analgesic consumption during 24 hours: Compared with the control group,The postoperative analgesic consumption during 24 hours was less in the TAP group.(SMD =-0.99,95% CI:-1.54 to-0.43;p=0.0005).7.Comparison of complication after operation in two groups: The different between complication after operation of TAP group and control group were not statistically significant(OR=0.55,95%CI:0.30~1.01;p=0.05).Conclusious:1.TAP applied in laparoscopic cholecystectomy can reduce the patient's Pain intensity score at 6 hours of moving and rest,Pain intensity score at 24 hours of moving and rest,The postoperative analgesic consumption during 24 hours,accelerated rehabilitation after laparoscopic cholecystectomy.2.In ambulate and complication after operation,The different between TAP group and control group were not statistically significant.3.In conclusion,TAP applied in laparoscopic cholecystectomy were safe and effective.Because of bounded in our study,further multicenter controlled clinical trials are needed to provide theoretical support.