PDF(Pubmed)
Abstract：
UNASSIGNED: Although laparoscopic cholecystectomy (LC) is a minimally invasive surgery, it can cause moderate to severe postoperative pain. Erector spinae plane (ESP) and transversus abdominis plane (TAP) blocks are considered effective means for pain management in such cases; however, there is inconclusive evidence regarding their analgesic efficacy. This meta-analysis aimed to compare the efficacy of ESP block and TAP block for pain control in LC.
UNASSIGNED: We systematically searched Medline, PubMed, Scopus, Embase, and Google Scholar until 26 January 2024. All randomized clinical trials compared the efficacy of erector spinae plane block (ESPB) and transversus abdominis plane block (TAPB) for postoperative pain relief after LC. The primary outcomes were pain scores at rest and on movement at 1, 2, 6, 12, and 24 h postoperatively. The secondary outcomes were total opioid consumption, first analgesia request time, and rates of postoperative nausea and vomiting. We analyzed all the data using RevMan 5.4.
UNASSIGNED: A total of 8 RCTs, involving 542 patients (271 in the ESPB group and 271 in the TAPB group), were included in the analysis. The ESP block demonstrated statistically significant lower pain scores at rest and on movement than the TAP block at all-time points except at the 1st and 6th h on movement postoperatively; however, these differences were not considered clinically significant. Additionally, patients who received the ESP block required less morphine and had a longer time before requesting their first dose of analgesia. There were no significant differences in postoperative nausea and vomiting incidence between the two groups.
UNASSIGNED: In patients undergoing LC, there is moderate evidence to suggest that the ESP block is effective in reducing pain severity, morphine equivalent consumption, and the time before the first analgesia request when compared to the TAP block during the early postoperative period.Systematic review registration: PROSPERO CRD42024505635, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024505635.
UNASSIGNED: We systematically searched Medline, PubMed, Scopus, Embase, and Google Scholar until 26 January 2024. All randomized clinical trials compared the efficacy of erector spinae plane block (ESPB) and transversus abdominis plane block (TAPB) for postoperative pain relief after LC. The primary outcomes were pain scores at rest and on movement at 1, 2, 6, 12, and 24 h postoperatively. The secondary outcomes were total opioid consumption, first analgesia request time, and rates of postoperative nausea and vomiting. We analyzed all the data using RevMan 5.4.
UNASSIGNED: A total of 8 RCTs, involving 542 patients (271 in the ESPB group and 271 in the TAPB group), were included in the analysis. The ESP block demonstrated statistically significant lower pain scores at rest and on movement than the TAP block at all-time points except at the 1st and 6th h on movement postoperatively; however, these differences were not considered clinically significant. Additionally, patients who received the ESP block required less morphine and had a longer time before requesting their first dose of analgesia. There were no significant differences in postoperative nausea and vomiting incidence between the two groups.
UNASSIGNED: In patients undergoing LC, there is moderate evidence to suggest that the ESP block is effective in reducing pain severity, morphine equivalent consumption, and the time before the first analgesia request when compared to the TAP block during the early postoperative period.Systematic review registration: PROSPERO CRD42024505635, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024505635.
摘要：
■尽管腹腔镜胆囊切除术（LC）是一种微创手术，它可以引起中度至重度的术后疼痛。在这种情况下，竖脊肌平面（ESP）和腹横肌平面（TAP）阻滞被认为是治疗疼痛的有效手段；然而，关于它们的镇痛效果尚无定论。这项荟萃分析旨在比较ESP阻滞和TAP阻滞对LC疼痛控制的疗效。
■我们系统地搜索了Medline，PubMed,Scopus,Embase,和谷歌学者直到2024年1月26日。所有随机临床试验都比较了直立脊肌平面阻滞（ESPB）和腹横肌平面阻滞（TAPB）对LC术后疼痛缓解的疗效。主要结果是术后1、2、6、12和24小时休息和运动时的疼痛评分。次要结果是阿片类药物的总消费量，第一次镇痛请求时间，术后恶心和呕吐的发生率。我们使用RevMan5.4分析了所有数据。
■总共8个RCT，涉及542名患者（ESPB组271名，TAPB组271名），包括在分析中。在所有时间点，除术后运动的第1和第6小时外，ESP阻滞在休息和运动时的疼痛评分均比TAP阻滞在统计学上显着降低；但是，这些差异被认为无临床意义.此外,接受ESP阻滞的患者需要较少的吗啡,并且在要求首次镇痛前需要较长的时间.两组患者术后恶心呕吐发生率差异无统计学意义。
■在接受LC的患者中，有适度的证据表明，ESP阻滞可有效减轻疼痛严重程度，吗啡等效消耗量，以及与术后早期TAP阻滞相比，首次镇痛请求之前的时间。系统审查注册：PROSPEROCRD42024505635，https://www。crd.约克。AC.uk/prospro/display_record.php?ID=CRD42024505635。
■我们系统地搜索了Medline，PubMed,Scopus,Embase,和谷歌学者直到2024年1月26日。所有随机临床试验都比较了直立脊肌平面阻滞（ESPB）和腹横肌平面阻滞（TAPB）对LC术后疼痛缓解的疗效。主要结果是术后1、2、6、12和24小时休息和运动时的疼痛评分。次要结果是阿片类药物的总消费量，第一次镇痛请求时间，术后恶心和呕吐的发生率。我们使用RevMan5.4分析了所有数据。
■总共8个RCT，涉及542名患者（ESPB组271名，TAPB组271名），包括在分析中。在所有时间点，除术后运动的第1和第6小时外，ESP阻滞在休息和运动时的疼痛评分均比TAP阻滞在统计学上显着降低；但是，这些差异被认为无临床意义.此外,接受ESP阻滞的患者需要较少的吗啡,并且在要求首次镇痛前需要较长的时间.两组患者术后恶心呕吐发生率差异无统计学意义。
■在接受LC的患者中，有适度的证据表明，ESP阻滞可有效减轻疼痛严重程度，吗啡等效消耗量，以及与术后早期TAP阻滞相比，首次镇痛请求之前的时间。系统审查注册：PROSPEROCRD42024505635，https://www。crd.约克。AC.uk/prospro/display_record.php?ID=CRD42024505635。
