Evidence map›Paper›PMID 33033957›Full record

SynthesisCanadian journal of anaesthesia = Journal canadien d'anesthesie2020

Transversus abdominis plane block compared with wound infiltration for postoperative analgesia following Cesarean delivery: a systematic review and network meta-analysis.

Pervez Sultan, Selina D Patel, Sandra Jadin, Brendan Carvalho, Stephen H Halpern

Erratum issuedAbstract readSystematic ReviewNetwork Meta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Canadian journal of anaesthesia = Journal canadien d'anesthesie, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 20 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 5 pooled it
5.3field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 5 syntheses or guidelines pooled it, 49 citations in OpenAlex.

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  8. Clinical Efficacy of Single-Journal of pain research · 2025
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  10. Local anesthetic dosing for fascial plane blocks to avoid systemic toxicity: a narrative review.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2025
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 2 countries.

Pervez SultanDepartment of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, CA, USA. psultan@stanford.edu.ORCID http://orcid.org/0000-0002-7770-0289
Selina D PatelDepartment of Anesthesia, Pain and Perioperative Medicine, University of Miami Miller School of Medicine, Miami, FL, USA.
Sandra JadinDepartment of Anesthesia, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Brendan CarvalhoDepartment of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, CA, USA.
Stephen H HalpernDepartment of Anesthesia, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Stanford Medicine · USSunnybrook Health Science Centre · CAUniversity of Miami · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis systematic review and network meta-analysis (NMA) compared postoperative analgesic efficacy of transversus abdominis plane (TAP) blocks with that of wound infiltration for Cesarean delivery (CD) without long-acting neuraxial opioid administration.

methodsWe sought randomized-controlled trials comparing TAP vs wound infiltration, and inactive control vs either TAP or wound infiltration. Wound infiltration included single-dose infiltration (WI), or continuous infusion via a catheter (WC). The primary outcome was 24 hr opioid consumption. Secondary outcomes included 12 and 24 hr pain scores (resting and movement), time to first analgesia request, incidence of postoperative nausea and vomiting (PONV), maternal sedation, and pruritus. We performed a NMA incorporating both direct and indirect comparisons and reported standardized mean differences and odds ratios with 95% confidence intervals for continuous and dichotomous outcomes.

resultsForty-two studies were included, comprising 2,906 participants. Transversus abdominis plane blocks and WC were associated with significantly lower 24 hr opioid consumption than inactive controls, but there were no significant differences between WI and inactive controls. There was no statistically significant difference in 24 hr opioid consumption between TAP blocks and WC or WI techniques. The network ranking of treatments was TAP block, followed by WC or WI. No significant differences were shown between TAP, WC, and WI groups for 24 hr pain scores, time to first analgesia, PONV, sedation, and pruritus. Quality of evidence was moderate for most of the outcomes assessed.

conclusionIn the absence of long-acting neuraxial opioid after CD, single-dose TAP blocks and WC are effective opioid-sparing strategies.

Indexed as

AnalgesiaNerve BlockAbdominal MusclesAnalgesics, OpioidFemaleHumansPostoperative PainPregnancyAnalgesics, OpioidCesarean deliverylocal anestheticpainperipheral nerve blockpostoperativeregional anesthesiatransversus abdominis plane blockwound catheterwound infiltration

Identifiers

PMID33033957
OpenAlexW4253753662

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.