{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T07:15:17Z","timestamp":1772781317813,"version":"3.50.1"},"reference-count":37,"publisher":"Federa\u00e7\u00e3o das Associa\u00e7\u00f5es de Ginecologia e Obstetr\u00edcia","issue":"01","license":[{"start":{"date-parts":[[2022,1,29]],"date-time":"2022-01-29T00:00:00Z","timestamp":1643414400000},"content-version":"vor","delay-in-days":28,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev Bras Ginecol Obstet"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objective\u2003To summarize the available evidence of TAP Block in efficacy in laparoscopic or robotic hysterectomy.<\/jats:p><jats:p>\n          Data Sources\u2003We searched databases and gray literature for randomized controlled trials in which transversus abdominis plane (TAP) block was compared with placebo or with no treatment in patients who underwent laparoscopic or robot-assisted hysterectomy.<\/jats:p><jats:p>\n          Method of Study Selection\u2003Two researchers independently evaluated the eligibility of the selected articles.<\/jats:p><jats:p>\n          Tabulation, Integration, and Results\u2003Seven studies were selected, involving 518 patients. Early postoperative pain showed a difference in the mean mean difference (MD): - 1.17 (95% confidence interval [CI]: - 1.87\u20130.46) in pain scale scores (I2\u2009=\u200968%), which was statistically significant in favor of using TAP block, but without clinical relevance; late postoperative pain: DM 0.001 (95%CI: - 0.43\u20130.44; I2\u2009=\u200969%); opioid requirement: DM 0.36 (95%CI: - 0.94\u20131.68; I2\u2009=\u200980%); and incidence of nausea and vomiting with a difference of 95%CI\u2009=\u2009- 0.11 (- 0.215\u20130.006) in favor of TAP.<\/jats:p><jats:p>\n          Conclusion\u2003With moderate strength of evidence, due to the high heterogeneity and imbalance in baseline characteristics among studies, the results indicate that TAP block should not be considered as a clinically relevant analgesic technique to improve postoperative pain in laparoscopic or robotic hysterectomy, despite statistical significance in early postoperative pain scale scores.<\/jats:p><jats:p>\n          Clinical Trial Number and Registry:\u2003PROSPERO ID - CRD42018103573.<\/jats:p>","DOI":"10.1055\/s-0041-1740595","type":"journal-article","created":{"date-parts":[[2022,1,29]],"date-time":"2022-01-29T23:30:32Z","timestamp":1643499032000},"page":"055-066","source":"Crossref","is-referenced-by-count":11,"title":["Efficacy of Transversus Abdominis Plane Block in the Reduction of Pain and Opioid Requirement in Laparoscopic and Robot-assisted Hysterectomy: A Systematic Review and Meta-analysis"],"prefix":"10.61622","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3903-3697","authenticated-orcid":false,"given":"Claudia","family":"L\u00f3pez-Ruiz","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Cl\u00ednica del Prado, Medell\u00edn, Colombia"},{"name":"School of Graduate Studies, School of Medicine, CES University, Medell\u00edn, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5297-5171","authenticated-orcid":false,"given":"Jerutsa Catalina","family":"Orjuela","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Cl\u00ednica del Prado, Medell\u00edn, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2293-0431","authenticated-orcid":false,"given":"Diego Fernando","family":"Rojas-Gualdr\u00f3n","sequence":"additional","affiliation":[{"name":"School of Graduate Studies, School of Medicine, CES University, Medell\u00edn, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5159-8792","authenticated-orcid":false,"given":"Marcela","family":"Jimenez-Arango","sequence":"additional","affiliation":[{"name":"School of Graduate Studies, School of Medicine, CES University, Medell\u00edn, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6707-4168","authenticated-orcid":false,"given":"Jos\u00e9 Fernando de los","family":"R\u00edos","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Cl\u00ednica del Prado, Medell\u00edn, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0665-5310","authenticated-orcid":false,"given":"Elsa Maria","family":"V\u00e1squez-Trespalacios","sequence":"additional","affiliation":[{"name":"School of Graduate Studies, School of Medicine, CES University, Medell\u00edn, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3943-5645","authenticated-orcid":false,"given":"Claudia","family":"Vargas","sequence":"additional","affiliation":[{"name":"American Association of Gynecologic Laparoscopists, Medell\u00edn, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"47794","published-online":{"date-parts":[[2022,1,29]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1016\/s1071-5576(01)00145-9","article-title":"Pelvic nerve plexus trauma at radical and simple hysterectomy: a quantitative study of nerve types in the uterine supporting ligaments","volume":"9","author":"S A Butler-Manuel","year":"2002","journal-title":"J Soc Gynecol Investig"},{"issue":"10","key":"ref2","doi-asserted-by":"publisher","first-page":"1000","DOI":"10.1007\/BF03016591","article-title":"Preemptive analgesia I: physiological pathways and pharmacological modalities","volume":"48","author":"D J Kelly","year":"2001","journal-title":"Can J Anaesth"},{"issue":"08","key":"ref3","doi-asserted-by":"publisher","first-page":"664","DOI":"10.1016\/s1701-2163(16)32552-x","article-title":"Assessment of patient satisfaction with postoperative pain management after ambulatory gynaecologic laparoscopy","volume":"29","author":"D Lovatsis","year":"2007","journal-title":"J Obstet Gynaecol Can"},{"issue":"04","key":"ref4","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1136\/rapm-2018-100024","article-title":"Pain management after laparoscopic hysterectomy: systematic review of literature and PROSPECT recommendations","volume":"44","author":"P Lirk","year":"2019","journal-title":"Reg Anesth Pain Med"},{"issue":"02","key":"ref5","first-page":"21","article-title":"Farmacolog\u00eda de los opioides","volume":"17","author":"Y \u00c1lvarez","year":"2005","journal-title":"Adicciones"},{"issue":"04","key":"ref6","doi-asserted-by":"publisher","first-page":"715","DOI":"10.1097\/SLA.0000000000002117","article-title":"Effect of preoperative opioid exposure on healthcare utilization and expenditures following elective abdominal surgery","volume":"265","author":"J F Waljee","year":"2017","journal-title":"Ann Surg"},{"issue":"07","key":"ref7","doi-asserted-by":"publisher","first-page":"2402","DOI":"10.1007\/s11999-015-4173-5","article-title":"Preoperative opioid misuse is associated with increased morbidity and mortality after elective orthopaedic surgery","volume":"473","author":"M E Menendez","year":"2015","journal-title":"Clin Orthop Relat Res"},{"issue":"02","key":"ref8","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1016\/j.anclin.2010.02.011","article-title":"Postoperative pain management after ambulatory surgery: role of multimodal analgesia","volume":"28","author":"O L Elvir-Lazo","year":"2010","journal-title":"Anesthesiol Clin"},{"issue":"10","key":"ref9","doi-asserted-by":"publisher","first-page":"1024","DOI":"10.1046\/j.1365-2044.2001.02279-40.x","article-title":"Abdominal field block: a new approach via the lumbar triangle","volume":"56","author":"A N Rafi","year":"2001","journal-title":"Anaesthesia"},{"issue":"01","key":"ref10","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1007\/s00404-012-2698-3","article-title":"Ultrasound-guided transversus abdominal plane block with multimodal analgesia for pain management after total abdominal hysterectomy","volume":"288","author":"I Gasanova","year":"2013","journal-title":"Arch Gynecol Obstet"},{"issue":"02","key":"ref11","doi-asserted-by":"publisher","first-page":"161","DOI":"10.4103\/1658-354X.130683","article-title":"Addition of dexmedetomidine to bupivacaine in transversus abdominis plane block potentiates post-operative pain relief among abdominal hysterectomy patients: A prospective randomized controlled trial","volume":"8","author":"W A Almarakbi","year":"2014","journal-title":"Saudi J Anaesth"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1186\/s13104-016-1864-2","article-title":"Adding a transversus abdominis plane block to parenteral opioid for postoperative analgesia following trans-abdominal hysterectomy in a low resource setting: a prospective, randomised, double blind, controlled study","volume":"9","author":"N Moyo","year":"2016","journal-title":"BMC Res Notes"},{"issue":"06","key":"ref13","doi-asserted-by":"publisher","first-page":"1230","DOI":"10.1097\/AOG.0b013e318236f67f","article-title":"Transversus abdominis plane infiltration and quality of recovery after laparoscopic hysterectomy: a randomized controlled trial","volume":"118","author":"G S De Oliveira Jr","year":"2011","journal-title":"Obstet Gynecol"},{"issue":"05","key":"ref14","doi-asserted-by":"publisher","first-page":"419.e1","DOI":"10.1016\/j.ajog.2012.06.052","article-title":"Randomized trial of transversus abdominis plane block at total laparoscopic hysterectomy: effect of regional analgesia on quality of recovery","volume":"207","author":"S M Kane","year":"2012","journal-title":"Am J Obstet Gynecol"},{"issue":"04","key":"ref15","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1111\/aogs.12351","article-title":"Transversus abdominis plane block after ambulatory total laparoscopic hysterectomy: randomized controlled trial","volume":"93","author":"G A Calle","year":"2014","journal-title":"Acta Obstet Gynecol Scand"},{"issue":"02","key":"ref16","doi-asserted-by":"publisher","first-page":"488","DOI":"10.1213\/ANE.0000000000001267","article-title":"Transversus abdominis plane block for postoperative analgesia in patients undergoing total laparoscopic hysterectomy: a randomized, controlled, observer-blinded trial","volume":"123","author":"D Ghisi","year":"2016","journal-title":"Anesth Analg"},{"issue":"03","key":"ref17","doi-asserted-by":"publisher","first-page":"561","DOI":"10.4103\/0259-1162.186620","article-title":"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","volume":"10","author":"E P Bava","year":"2016","journal-title":"Anesth Essays Res"},{"issue":"05","key":"ref18","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1016\/j.redar.2016.12.004","article-title":"Efficacy of ultrasound-guided transversus abdominis plane block in laparoscopic hysterectomy. Clinical trial","volume":"64","author":"D S Guardabassi","year":"2017","journal-title":"Rev Esp Anestesiol Reanim"},{"issue":"03","key":"ref19","doi-asserted-by":"publisher","first-page":"460","DOI":"10.1016\/j.ygyno.2014.11.013","article-title":"Transversus abdominis plane block in robotic gynecologic oncology: a randomized, placebo-controlled trial","volume":"136","author":"B T Hotujec","year":"2015","journal-title":"Gynecol Oncol"},{"issue":"03","key":"ref20","doi-asserted-by":"publisher","first-page":"609","DOI":"10.1016\/j.ygyno.2015.06.008","article-title":"Ultrasound guided subcostal transversus abdominis plane (TAP) infiltration with liposomal bupivacaine for patients undergoing robotic assisted hysterectomy: A prospective randomized controlled study","volume":"138","author":"J Hutchins","year":"2015","journal-title":"Gynecol Oncol"},{"issue":"07","key":"ref21","doi-asserted-by":"publisher","first-page":"928","DOI":"10.1111\/aas.12516","article-title":"Transversus abdominis plane (TAP) block after robot-assisted laparoscopic hysterectomy: a randomised clinical trial","volume":"59","author":"H Torup","year":"2015","journal-title":"Acta Anaesthesiol Scand"},{"issue":"01","key":"ref22","first-page":"41","article-title":"Opioid-sparing effects of transversus abdominis plane block in elective hysterectomy: a systematic review and meta-analysis","volume":"86","author":"T D Tubog","year":"2018","journal-title":"AANA J"},{"issue":"01","key":"ref23","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1016\/j.jmig.2018.04.020","article-title":"Transversus abdominis plane block for post hysterectomy pain: a systematic review and meta-analysis","volume":"26","author":"V Bacal","year":"2019","journal-title":"J Minim Invasive Gynecol"},{"issue":"01","key":"ref24","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/2046-4053-4-1","article-title":"Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement","volume":"4","author":"D Moher","year":"2015","journal-title":"Syst Rev"},{"issue":"01","key":"ref25","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1186\/2046-4053-3-54","article-title":"Study flow diagrams in Cochrane systematic review updates: an adapted PRISMA flow diagram","volume":"3","author":"E Stovold","year":"2014","journal-title":"Syst Rev"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1186\/s13643-016-0259-8","article-title":"Evaluation of the Cochrane tool for assessing risk of bias in randomized clinical trials: overview of published comments and analysis of user practice in Cochrane and non-Cochrane reviews","volume":"5","author":"L J\u00f8rgensen","year":"2016","journal-title":"Syst Rev"},{"issue":"06","key":"ref27","doi-asserted-by":"publisher","first-page":"639","DOI":"10.1067\/mem.2001.118012","article-title":"Clinically significant changes in pain along the visual analog scale","volume":"38","author":"S B Bird","year":"2001","journal-title":"Ann Emerg Med"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1016\/s0304-3959(03)00176-3","article-title":"What decline in pain intensity is meaningful to patients with acute pain?","volume":"105","author":"M S Cepeda","year":"2003","journal-title":"Pain"},{"issue":"06","key":"ref29","doi-asserted-by":"publisher","first-page":"633","DOI":"10.1067\/mem.2001.118863","article-title":"Prospective validation of clinically important changes in pain severity measured on a visual analog scale","volume":"38","author":"E J Gallagher","year":"2001","journal-title":"Ann Emerg Med"},{"issue":"04","key":"ref30","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1053\/ajem.2002.33778","article-title":"Reliability and validity of a visual analog scale for acute abdominal pain in the ED","volume":"20","author":"E J Gallagher","year":"2002","journal-title":"Am J Emerg Med"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1186\/1471-2288-14-135","article-title":"Estimating the sample mean and standard deviation from the sample size, median, range and\/or interquartile range","volume":"14","author":"X Wan","year":"2014","journal-title":"BMC Med Res Methodol"},{"issue":"13","key":"ref32","doi-asserted-by":"publisher","first-page":"2116","DOI":"10.1002\/sim.6481","article-title":"Neither fixed nor random: weighted least squares meta-analysis","volume":"34","author":"T D Stanley","year":"2015","journal-title":"Stat Med"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1016\/j.jclinepi.2017.10.001","article-title":"A simple technique investigating baseline heterogeneity helped to eliminate potential bias in meta-analyses","volume":"95","author":"A Hicks","year":"2018","journal-title":"J Clin Epidemiol"},{"issue":"05","key":"ref34","doi-asserted-by":"publisher","first-page":"511","DOI":"10.1016\/j.jclinepi.2011.10.009","article-title":"Graphical augmentations to the funnel plot assess the impact of additional evidence on a meta-analysis","volume":"65","author":"D Langan","year":"2012","journal-title":"J Clin Epidemiol"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"1490","DOI":"10.1136\/bmj.328.7454.1490","article-title":"Grading quality of evidence and strength of recommendations","volume":"328","author":"D Atkins","year":"2004","journal-title":"BMJ"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1136\/bmj.37984.623889.F6","article-title":"The eVALuate study: two parallel dequated trials, one comparing laparoscopic with abdominal hysterectomy, the other comparing laparoscopic with vaginal hysterectomy","volume":"328","author":"R Garry","year":"2004","journal-title":"BMJ"},{"issue":"04","key":"ref37","doi-asserted-by":"publisher","first-page":"1279","DOI":"10.1213\/ane.0b013e3181b0f0bb","article-title":"A comparison of intravenous oxycodone and intravenous morphine in patient-controlled postoperative analgesia after laparoscopic hysterectomy","volume":"109","author":"H Lenz","year":"2009","journal-title":"Anesth Analg"}],"container-title":["Revista Brasileira de Ginecologia e Obstetr\u00edcia \/ RBGO Gynecology and Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journalrbgo.org\/article\/efficacy-of-transversus-abdominis-plane-block-in-the-reduction-of-pain-and-opioid-requirement-in-laparoscopic-and-robot-assisted-hysterectomy-a-systematic-review-and-meta-analysis\/","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0041-1740595.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,18]],"date-time":"2024-07-18T20:56:53Z","timestamp":1721336213000},"score":1,"resource":{"primary":{"URL":"https:\/\/journalrbgo.org\/article\/efficacy-of-transversus-abdominis-plane-block-in-the-reduction-of-pain-and-opioid-requirement-in-laparoscopic-and-robot-assisted-hysterectomy-a-systematic-review-and-meta-analysis\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1]]},"references-count":37,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2022,1,29]]},"published-print":{"date-parts":[[2022,1]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0041-1740595","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0100-7203","1806-9339"],"issn-type":[{"value":"0100-7203","type":"print"},{"value":"1806-9339","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1]]}}}