Efficacy and safety of laparoscopic-guided transversus abdominis plane block versus port-site local anesthetic infiltration in laparoscopic cholecystectomy: A systematic review, meta-analysis, and trial sequential analysis
Abstract
Background: Postoperative pain following laparoscopic cholecystectomy remains a major clinical concern, and the optimal method of local anesthetic delivery is unresolved. This systematic review and meta-analysis evaluated the efficacy and safety of laparoscopic-guided transversus abdominis plane (LTAP) block versus port-site local anesthetic infiltration for reducing pain, opioid use, and improving recovery in patients undergoing LC.
Methods: This review was conducted per Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines and was prospectively registered on the International Prospective Register of Systematic Reviews (CRD420261344930). PubMed, Embase, and the Cochrane Library were searched from inception to March 2026, without language restriction, for randomized controlled trials (RCTs) comparing LTAP block with standard port-site local anesthetic infiltration in adults undergoing LC. Eligible studies were RCTs reporting at least 1 clinically relevant outcome (postoperative pain, operative time, shoulder pain, rescue analgesia, hospital stay, or discharge within 24 hours); observational studies, non-randomized designs, and reviews were excluded. Risk of bias was assessed independently by 2 reviewers using the Cochrane Risk of Bias 2.0 tool. Data were pooled using a random-effects model (Mantel-Haenszel method with DerSimonian-Laird estimation) in Review Manager version 5.4.1, with heterogeneity quantified using the I-squared statistic…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 711 participants or records.
Read the paper
Related studies
- Effect of dexamethasone as an analgesic adjuvant to multimodal pain treatment after total knee arthroplasty: randomised clinical trial
- Effect of a Postoperative Multimodal Opioid-Sparing Protocol vs Standard Opioid Prescribing on Postoperative Opioid Consumption After Knee or Shoulder Arthroscopy: A Randomized Clinical Trial
- Comparison of the Post-Caesarean Analgesic Effect of Adding Dexmedetomidine to Paracetamol and Ketorolac: A Randomized Clinical Trial
- A triple-blind randomized clinical trial of different associations between dexamethasone and non-steroids anti-inflammatories for preemptive action in third molar extractions
- An open label randomized clinical trial of Indomethacin for mild and moderate hospitalised Covid-19 patients
- Oral paracetamol and/or ibuprofen for treating pain after soft tissue injuries: Single centre double-blind, randomised controlled clinical trial
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.