Regional anesthesia in colorectal laparoscopy: a retrospective comparison of quadratus lumborum and TAP blocks

Effective postoperative pain control is pivotal in enhancing recovery following laparoscopic colorectal surgery. Regional anesthesia techniques such as the transversus abdominis plane (TAP) block and the quadratus lumborum (QL) block have gained prominence as components of multimodal analgesia. However, their comparative efficacy remains underexplored. This retrospective observational cohort study analyzed data from 289 patients undergoing laparoscopic colon surgery. Patients were stratified into three groups: TAP block (Group A, <i>n</i> = 54), QL block (Group B, <i>n</i> = 62), and no regional block (Group C, <i>n</i> = 173). Primary endpoints included time to first analgesic administration and total analgesic consumption (opioids and non-opioids). Statistical analyses were conducted using R (v4.4.2) and Jamovi (v2.3), with significance set at <i>P</i> < 0.05. Group B (QL block) demonstrated significantly reduced opioid consumption (mean 13.16 ± 2.69 mg) compared to both Group A (16.80 ± 5.51 mg) and Group C (18.03 ± 4.29 mg), <i>P</i> < 0.001. Time to first analgesic request was longer in Group B (16.06 ± 2.53 h), indicating more durable analgesia. Non-opioid usage (paracetamol, tramadol, nefopam) was similarly lower in Group B across all comparisons (<i>P</i> < 0.001). Group B also exhibited a significantly shorter hospital stay (4.87 ± 1.14 days) relative to Groups A and C. The QL block was associated with superior postoperative analgesia, reduced opioid and adjunct analgesic requirements, prolonged pain-free intervals, and accelerated postoperative recovery in laparoscopic colorectal surgery. These findings underscore QL block as a potent element of opioid-sparing, multimodal analgesic strategies and support its broader adoption in enhanced recovery protocols.