Efficacy of transversus abdominis plane blocks in inguinal hernia repair: a systematic review and meta-analysis of randomized controlled trials
Abstract
Objective: To evaluate the efficacy of transversus abdominis plane block (TAPB) in reducing postoperative pain and opioid consumption following inguinal hernia repair.
Methods: A systematic review and meta-analysis of 23 randomized controlled trials (1863 patients) was conducted following PRISMA guidelines. Primary outcome was resting pain scores at 24 hours postoperatively; secondary outcomes included dynamic pain scores, morphine consumption, and procedural metrics. Risk of bias was assessed using Cochrane RoB 2, and evidence quality was graded via GRADE.
Results: Pooled analysis revealed no significant difference in 24-hour resting pain between TAPB and control groups (MD: -0.24, 95% CI: -0.80 to 0.32; P = 0.41), with high heterogeneity (I 2 = 99%). Control groups exhibited superior pain control at 8 hours ( P = 0.02). No differences were observed in morphine consumption ( P = 0.49), time to rescue analgesia ( P = 0.40), or patient satisfaction ( P = 0.50). Evidence quality ranged from low to high.
Conclusion: TAPB does not confer consistent analgesic benefits over alternative interventions in inguinal hernia repair. Standardized protocols and larger trials are warranted to clarify their role in multimodal pain management.
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: 1,863 participants or records.
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