Antonio Schiattarella, Pasquale De Franciscis, Gaetano Riemma, Marco La Verde, Irene Esposito, Maddalena Morlando, Luigi Della Corte, Giovanni Sisti, Stefano Cianci, Pasquale Sansone, Riemma, Gaetano, Schiattarella, Antonio, Cianci, Stefano, La Verde, Marco, Morlando, Maddalena, Sisti, Giovanni, Esposito, Irene, DELLA CORTE, Luigi, Sansone, Pasquale, De Franciscis, Pasquale, Riemma, G., Schiattarella, A., Cianci, S., La Verde, M., Morlando, M., Sisti, G., Esposito, I., Della Corte, L., Sansone, P., and De Franciscis, P.
Background: Transversus abdominis plane (TAP) block and wound infiltration (WI) with local anesthetics are used for postoperative analgesia after cesarean section (CS), reducing the need for administration of opioids. Objective: To compare the analgesic effect of TAP block related to WI. Search strategy: MEDLINE, Scopus, ClinicalTrials.gov, EMBASE, Cochrane Library, and CINAHL were searched from inception until April 2020. Selection criteria: Randomized controlled trials (RCTs) about women who underwent TAP block or WI after CS. Data collection and analysis: Relevant data were extracted and tabulated. Review Manager 5.3 was used for data analysis. Primary outcome was cumulative opioid consumption (COC) 24 and 48 h after CS. Main results: Five RCTs, enrolling 268 women, were included. There were no significant differences between the interventions regarding COC at 24 (mean difference [MD] -1.68, 95% confidence interval [CI] -6.29 to 2.93) and 48 hours (MD 1.28, 95% CI -10.44 to 13.00). Adverse effects (relative risk [RR] 0.93, 95% CI 0.75-1.16), gastrointestinal reactions (RR 1.30, 95% CI 0.46-3.68), or mild-moderate sedation (RR 1.12, 95% CI 0.72-1.74), pain scores, satisfaction of women, and withdrawals were similar between groups. Conclusions: There might be no significant advantages selecting TAP block over WI for post-CS analgesia.