• Gaetano Riemma, Antonio Schiattarella, Stefano Cianci, Marco La Verde, Maddalena Morlando, Giovanni Sisti, Irene Esposito, Luigi Della Corte, Pasquale Sansone, and Pasquale De Franciscis.
• Obstetrics and Gynecology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy.
• Int J Gynaecol Obstet. 2021 Jun 1; 153 (3): 383-392.

BackgroundTransversus 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.ObjectiveTo compare the analgesic effect of TAP block related to WI.Search StrategyMEDLINE, Scopus, ClinicalTrials.gov, EMBASE, Cochrane Library, and CINAHL were searched from inception until April 2020.Selection CriteriaRandomized controlled trials (RCTs) about women who underwent TAP block or WI after CS.Data Collection And AnalysisRelevant 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 ResultsFive 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.ConclusionsThere might be no significant advantages selecting TAP block over WI for post-CS analgesia.© 2020 International Federation of Gynecology and Obstetrics.

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