Transversus abdominis plane block reduces morphine use and pain after kidney removal surgery in patients

To systematically evaluate the effect of transversus abdominis plane block (TAPB) on postoperative analgesia after nephrectomy. A computerised search was conducted to identify randomised controlled trials (RCTs) evaluating TAPB for postoperative analgesia after nephrectomy from database inception to 31 January 2026 in the Cochrane Library, PubMed, Embase, Web of Science, China Biomedical Literature Service, Wanfang Data, and the China National Knowledge Infrastructure. Two researchers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was performed using Review Manager 5.4. The quality of evidence was graded using the GRADEpro system, and publication bias for endpoint indicator was assessed using Stata 17.0. Ten RCTs involving a total of 639 patients were included. The meta-analysis showed that, compared with the control group, the TAPB group demonstrated a significant reduction in intravenous morphine equivalents at 24-hour postoperative [MD = −16.67, 95% CI (−25.57, −7.77), p < 0.001]. Resting pain scores were significantly lower at 6-hour (p = 0.003), 12-hour (p < 0.001), and 24-hour (p = 0.020) postoperatively, although the difference at 2-hour (p = 0.160) and 4-hour (p = 0.100) was not statistically significant. Active pain scores were lower at 2-hour (p = 0.020), 4-hour (p < 0.001), 6-hour (p < 0.001), 12-hour (p = 0.002), and 24-hour (p < 0.001) postoperatively. TAPB did not prolong the time to first analgesia (p = 0.120) or postoperative hospital stay (p = 0.200), and it reduced the incidence of postoperative gastrointestinal adverse reactions (p < 0.001). Except for the absence of significant differences in resting pain scores at 2 and 4 hours postoperative, TAPB might reduce postoperative pain after nephrectomy, decreased postoperative opioid consumption, lowered postoperative pain scores, and reduced gastrointestinal adverse reactions.