Bibliographic record
Abstract
Ultrasound guidance has led a surge of interest in transversus abdominis plane (TAP) block for postoperative analgesia following abdominal surgery. Despite or because of the numerous descriptive applications and techniques that have recently populated the literature, results of comparative studies for TAP block have been inconsistent. This systematic review pragmatically addresses many unanswered questions, specifically the following: what are the effects of surgical procedure, block dose, block technique, and block timing on TAP block analgesia? Eighteen intermediate- to good-quality randomized trials that included diverse surgical procedures were identified. Improved analgesia was noted in patients undergoing laparotomy for colorectal surgery, laparoscopic cholecystectomy, and open and laparoscopic appendectomy. There was a trend toward superior analgesic outcomes when 15 mL of local anesthetic or more was used per side compared with lesser volumes. All 5 trials investigating TAP block performed in the triangle of Petit and 7 of 12 trials performed along the midaxillary line demonstrated some analgesic advantages. Eight of 9 trials using preincisional TAP block and 4 of 9 with postincisional block revealed better analgesic outcomes. Although the majority of trials reviewed suggest superior early pain control, we were unable to definitively identify the surgical procedures, dosing, techniques, and timing that provide optimal analgesia following TAP block. This review suggests that our understanding of the TAP block and its role in contemporary practice remains limited.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".