Modified Thoracoabdominal Nerves Block Through Perichondral Approach: A Systematic Review and Meta-analysis

Insun Park; Jae Hyon Park; Chang-Hoon Koo; Jin-Hee Kim; Bon-Wook Koo; Jung-Hee Ryu; Ah-Young Oh

doi:10.1016/j.jopan.2024.03.014

Modified Thoracoabdominal Nerves Block Through Perichondral Approach: A Systematic Review and Meta-analysis

J Perianesth Nurs. 2024 Jul 15:S1089-9472(24)00110-2. doi: 10.1016/j.jopan.2024.03.014. Online ahead of print.

Authors

Insun Park¹, Jae Hyon Park², Chang-Hoon Koo³, Jin-Hee Kim³, Bon-Wook Koo³, Jung-Hee Ryu¹, Ah-Young Oh⁴

Affiliations

¹ Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Republic of Korea; Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicines, Seoul, Republic of Korea.
² Department of Radiology, The Armed Forces Daejeon Hospital, Daejeon, Republic of Korea.
³ Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Republic of Korea.
⁴ Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Republic of Korea; Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicines, Seoul, Republic of Korea. Electronic address: ohahyoung@hanmail.net.

PMID: 39023478
DOI: 10.1016/j.jopan.2024.03.014

Abstract

Purpose: This systematic review and meta-analysis aimed to investigate the postoperative analgesic efficacy and safety of the modified thoracoabdominal nerve block through the perichondral approach (M-TAPA) in abdominal surgeries.

Design: Systematic review and meta-analysis.

Methods: We searched electronic databases to identify relevant studies comparing M-TAPA with conventional analgesic techniques. The primary outcome was the requirement for rescue analgesia at 12 and 24 hours postsurgery. Secondary outcomes included the 11-point numerical rating scale pain scores at 0, 1, 2, 4, 6, 8, 12, and 24 hours following surgery, global quality of recovery scores, and postoperative adverse events.

Findings: Five randomized controlled trials involving 308 patients were analyzed. M-TAPA showed no significant difference in the requirement for rescue analgesia at 12 hours (relative risk [RR]: 0.87; 95% confidence interval [CI]: 0.62, 1.22; P = .424; I² = 40.7%; P_h = .185) and 24 hours (RR: 0.67; 95% CI: 0.22, 1.99; P = .252; I² = 90.3%; P_h < .001) postsurgery compared to non-M-TAPA. No significant differences in numerical rating scale pain scores or global quality of recovery scores were found between the two groups (all P < .05). However, M-TAPA was associated with a lower occurrence of nausea (RR: 0.37; 95% CI: 0.22, 0.68; P < .001; I² = 0%; P_h = .834), vomiting (RR: 0.32; 95% CI: 0.17, 0.62; P < .001; I² = 0%; P_h = .884), and itching (RR: 0.38; 95% CI: 0.21, 0.70; P = .002; I² = 0%; P_h = .826).

Conclusions: There was no significant difference in analgesic efficacy and safety between M-TAPA and non-M-TAPA techniques.

Keywords: analgesia; meta-analysis; pain; pain measurement; patient satisfaction; postoperative.