Surgery · 4 h ago
TAP and QL Blocks Show Similar Early Outcomes After Open Ventral Hernia Repair
A propensity score-matched registry analysis compared transversus abdominis plane (TAP) and quadratus lumborum (QL) blocks in 445 patients undergoing elective open ventral hernia repair. Length of stay and post-discharge opioid use were similar, while patients receiving QL blocks reported higher pain scores at 30 days.
- Matched registry analysis included 445 open-repair patients.
- Length of stay and opioid use were similar.
- QL recipients reported higher pain scores at 30 days.
- Observational findings do not establish causation.
Researchers analyzed data from the Abdominal Core Health Quality Collaborative for adults undergoing elective open ventral hernia repair between January 2023 and July 2025. After propensity score matching, the analysis included 333 patients who received TAP blocks and 112 who received QL blocks. Outcomes included hospital length of stay, opioid use after discharge, patient-reported pain and quality of life, and 30-day complications and readmissions.
Median length of stay was four days in both groups (p=0.07). At 30 days, 87% of TAP-block recipients and 90% of QL-block recipients reported no opioid use after discharge (p=0.5). Hernia-related quality-of-life scores, complications and readmissions were similar. However, PROMIS-3a pain scores were higher among QL-block recipients at 30 days (p=0.006).
The observational comparison does not establish that either block causes better outcomes. Length of stay was used as a surrogate for pain control, and the findings apply to elective open repairs in this registry population; they do not establish comparative effectiveness for minimally invasive repair. The results do not show an advantage for QL blocks on the measured early outcomes.
In practice
For adults undergoing elective open ventral hernia repair, this matched registry analysis found no significant difference between TAP and QL blocks in median hospital stay or opioid use after discharge at 30 days. QL-block recipients had higher 30-day PROMIS-3a pain scores, while hernia-related quality of life and complications were similar. Because this was an observational comparison, and length of stay was used as a pain-control surrogate, it does not establish that one block is superior or support changing practice; findings do not address minimally invasive repair.
AI-generated clinical interpretation · Not editor-reviewed
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Surgical Endoscopy: Comparing quadratus lumborum and transversus abdominis plane blocks for pain control after open ventral hernia repair: a propensity score-matched analysis of the Abdominal Core Health Quality Collaborative ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.