Outcomes of quadratus lumborum blocks for pain control after open abdominal wall reconstruction: a single institution retrospective analysis.

Abstract

<h4>Introduction</h4>Abdominal wall reconstruction (AWR) is associated with significant post-operative pain for which there is no standardized treatment regimen. Quadratus lumborum (QL) blocks have not been studied in open ventral hernia repair. This study reviews our institution's experience with QL blocks in open AWR.<h4>Methods</h4>A retrospective review from October 2022 to October 2024 was completed. Patients undergoing elective, open abdominal wall reconstruction who received pre-operative QL blocks were included. Variables analyzed included patient demographics, comorbidities, operative technique, mesh type, daily opioid consumption reported as morphine milliequivalents (MMEs), and length of stay. The primary outcome was MMEs consumed in the first 24 h after surgery.<h4>Results</h4>There were 102 patients included in the study. The first 24-hour median opioid MME consumption was 8 (IQR 0-67.5). The median MMEs peaked on day 2 at 47 (IQR 30-114) and then trended down each day. The median length of stay was 4.3 days (IQR 4.1-5.9). There were no complications related to the QL block procedure.<h4>Conclusion</h4>This is the first study to report on post-operative opioid consumption in patients receiving a quadratus lumborum block prior to open ventral hernia repair. We found patients consumed minimal MMEs in the first 24 h after surgery suggesting that QL blocks may provide analgesic benefit in abdominal wall reconstruction.