Calle et al. (2014)
1515 Calle GA, López CC, Sánchez E, Ríos JFDL, Vásquez EM, Serna E, et al. Transversus abdominis plane block after ambulatory total laparoscopic hysterectomy: randomized controlled trial. Acta Obstet Gynecol Scand. 2014;93(04):345-350. Doi: 10.1111/aogs.12351 https://doi.org/10.1111/aogs.12351...
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ColombiaPrado Clinic and CES University, Medellin |
Laparoscopic |
Patients with ASA surgical risk classification types 1 and 2; had no contraindications for administration of local anesthetics, NSAIDs, or acetaminophen; had an adequate level of understanding, i.e., being able to communicate by telephone and understand a numerical scale. |
Change in the standard anesthetic technique, hospitalization following hysterectomy, previous medical history of allergy to local anesthetics, and not being able to be reached by telephone |
Pain scale scores (VAS) at 24, 48, and 72 hours after surgery, opioid requirement after surgery |
Placebo |
100 / 97Sequence was generated using computer-generated randomization list in blocks, which were placed in sealed envelopes |
Triple blind: Patient, surgeon, and data analyst |
Bupivacaine 0.25%(96) |
I, II |
Laparoscopic-guided |
De Oliveira et al. (2011)
1313 De Oliveira GS Jr,Milad MP, Fitzgerald P, Rahmani R,McCarthy RJ. Transversus abdominis plane infiltration and quality of recovery after laparoscopic hysterectomy: a randomized controlled trial. Obstet Gynecol. 2011;118(06):1230-1237. Doi: 10.1097/AOG.0-b013e318236f67f https://doi.org/10.1097/AOG.0-b013e31823...
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United States of AmericaNorthwestern University, Chicago |
Laparoscopic |
Healthy women undergoing laparoscopic hysterectomy |
Patients with previous history of allergy to local anesthetics, long-term use of opioid analgesics or corticosteroids, and pregnancy |
Quality of Recovery (QoR-40) at 24h; pain numeric scale score at 30 minutes, 60 minutes, and 24 hours; time to opioid requirement and cumulative opioid consumption at 24 hours, and number of postoperative antiemetics |
Placebo |
22 / 23Individuals were randomized into three groups using a computer-generated table of random numbers, and group assignments were sealed in sequentially numbered envelopes |
Double blind: patients, anesthesia care providers |
Ropivacaine 0.5%100 |
I, II |
Ultrasound |
Ghisi et al. (2016)
1616 Ghisi D, Fanelli A, Vianello F, Gardini M, Mensi G, Colla LL, et al. Transversus abdominis plane block for postoperative analgesia in patients undergoing total laparoscopic hysterectomy: a randomized, controlled, observer-blinded trial. Anesth Analg. 2016;123 (02):488-492. Doi: 10.1213/ANE.0000000000001267 https://doi.org/10.1213/ANE.000000000000...
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ItalyInstituti Ospitalieri Cremona |
Laparoscopic |
Patients between 18 and 70 years old, undergoing elective total laparoscopic hysterectomy |
Chronic opioid therapy in the previous 3 months before surgery, conversion to open surgical technique, BMI > 30 kg/m2 or < 18 kg/m2, postoperative recovery in intensive care unit, chronic therapy with antidepressants, known diagnosis of epilepsy or therapy with antiepileptic drugs, bilirubin level > 3.0 mg/dL, aspartate aminotransferase and/or alanine aminotransferase > 250 IU, creatinine level >1.4 mg/dL, pregnancy or lactation, known allergy to any drug used in the study, local infection at the block site, and drug or alcohol addiction. |
Postoperative pain at rest and during movement using NRS of 0 to 10, at 2, 4, 6, and 24 hours. Morphine requirement 24 hours, incidence of postoperative nausea and vomiting (PONV) using the Apfel score |
No block |
22 / 22Patients were randomized into two groups using computer-generated sequence of numbers placed in sealed envelopes |
Single blind: observer (data collection) |
Levobupivacaine 0.375%(75) |
I - III |
Ultrasound |
Guardabassi et al. (2017)
1818 Guardabassi DS, Lupi S, Agejas R, Allub JM, García-Fornari G. Efficacy of ultrasound-guided transversus abdominis plane block in laparoscopic hysterectomy. Clinical trial. Rev Esp Anestesiol Reanim. 2017;64(05):257-261. Doi: 10.1016/j.redar.2016.12.004 https://doi.org/10.1016/j.redar.2016.12....
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ArgentinaHospital Italiano de Buenos Aires |
Laparoscopic |
Patients between 18 and 70 years old; BMI < 35 kg/m2; undergoing total laparoscopic hysterectomy |
Previous medical history of allergy to local anesthetics; psychiatric disorders or dementia, abdominal wall infection; chronic use of analgesics, chronic pain syndrome; diagnosed peripheral neuropathy; known allergy to analgesics or corticoids. |
Pain NRS: non-randomized study scores at 60 minutes, 2, 8, and 24 hours after surgery; opioid consumption during the first 24 postoperative hours; adverse effects on quality of sleep of the first night after surgery; episodes of nausea and vomit; Ramsay sedation scale |
No block |
20 / 20Non-probability sampling of consecutive case series.Random assignment using sealed envelopes |
Single-blind: Data analysts |
Ropivacaíne 0.5%(75) |
I, II |
Ultrasound |
Bava et al. (2016)
1717 Bava EP, Ramachandran R, Rewari V, Chandralekha , Bansal VK, Trikha A. Analgesic efficacy of ultrasound guided transversus abdominis plane block versus local anesthetic infiltration in adult patients undergoing single incision laparoscopic cholecystectomy: A randomized controlled trial. Anesth Essays Res. 2016;10 (03):561-567. Doi: 10.4103/0259-1162.186620 https://doi.org/10.4103/0259-1162.186620...
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ChinaDepartment of Anesthesiology and Operation, Hospital of People's Liberation Army. Xi'an |
Laparoscopic and LAVH |
Women scheduled for elective laparoscopic hysterectomy with benign lesions |
Patients with preoperative use of analgesics were excluded due to potential impact on postoperative analgesia requirement; BMI > 30 kg/m2; coagulopathy; contraindication for peripheral nerve block; any drug allergy |
Pain, with NRS: 30 and 60 minutes, 4, 8, 12, and 24 hoursPONV, Ramsay sedation scaleSatisfaction scores |
No block |
35 / 36Computer-generated randomization list in blocks, placed in sealed envelopes |
Double-blind: blinded to patients and data analysts, but not to members of the surgical and anesthesia care teams |
Ropivacaine 0.375%(112.5) |
— |
Ultrasound |
Kane et al. (2012)
1414 Kane SM, Garcia-Tomas V, Alejandro-Rodriguez M, Astley B, Pollard RR. Randomized trial of transversus abdominis plane block at total laparoscopic hysterectomy: effect of regional analgesia on quality of recovery. Am J Obstet Gynecol. 2012;207(05): 419.e1-419.e5. Doi: 10.1016/j.ajog.2012.06.052 https://doi.org/10.1016/j.ajog.2012.06.0...
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United States of AmericaMetrohealth Medical Center, Case Western Reserve University, Cleveland |
Laparoscopic and single-port |
All women undergoing laparoscopic hysterectomy by a single surgeon between April and September 2011 were approached to participate in this study. |
Patients on chronic pain narcotic medications, or if they had allergy to local anesthetic. |
Numeric visual analog scales for pain and opioid requirement at 2 and 24 hours after surgery; quality of recovery (QoR-40 survey) at postoperative day 1 |
No block |
28 / 29Computer-based block randomization |
Single-blind: blinded to data analysts |
Ropivacaine 0.5% with epinephrine(100) |
— |
Ultrasound |