The analgesic effect of transversalis fascia plane block after cesarean section: a systematic review and meta-analysis of randomized controlled trials
Minerva Anestesiologica, cilt.91, sa.12, ss.1181-1192, 2025 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 91 Sayı: 12
- Basım Tarihi: 2025
- Doi Numarası: 10.23736/s0375-9393.25.19105-0
- Dergi Adı: Minerva Anestesiologica
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE
- Sayfa Sayıları: ss.1181-1192
- Anahtar Kelimeler: Cesarean section, Analgesia, Conduction anesthesia
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
INTRODUCTION: Cesarean section is commonly linked to significant postoperative pain, which may hinder maternal recovery. Transversalis fascia plane block (TFPB) has emerged as a regional anesthesia technique that may enhance pain control and reduce opioid requirements. This study assesses the efficacy and safety of TFPB through a systematic review and meta-analysis of randomized controlled trials. eViDeNce acQUisiTioN: Following PrisMa guidelines and registered in ProsPero (crD420251000597), a systematic search of five databases was conducted up to March 7, 2025. Included studies were randomized controlled trials comparing TFPB with placebo, no block, or other regional techniques such as transversus abdominis plane block, quadratus lumborum block, or ilioinguinal-iliohypogastric nerve blocks. Outcomes reflecting analgesic efficacy included time to first analgesic request, pain scores (at rest and during movement), 24-hour opioid consumption, and the proportion of patients requiring rescue analgesia. opioid-related side effects were also assessed. EVIDENCE SYNTHESIS: Ten randomized controlled trials were included. TFPB significantly prolonged the time to first analgesic request compared to control or alternative techniques (SMD=2.328; 95% CI: 0.487 to 4.169; P=0.003) and reduced the need for rescue analgesia (OR=0.373; 95% CI: 0.172 to 0.81; P=0.013). Although the reduction in 24-hour opioid consumption was not statistically significant overall (SMD=-1.052; 95% CI: -2.549 to 0.445; P=0.169), subgroup analyses indicated benefit in selected settings. At 12 hours postoperatively, TFPB significantly reduced pain scores compared to placebo, both at rest (MD: -1.00; 95% CI: -1.756 to -0.244) and during movement (MD: -1.000; 95% CI: -1.749 to -0.251). coNclUsioNs: TFPB offers effective postoperative analgesia and reduces opioid use after cesarean section, with a safety profile comparable to other regional techniques.