To Block or Not to Block: A Propensity Score Matched Analysis of TAP Blocks in Ventral Hernia Repairs

Background Transversus abdominis plane (TAP) blocks reduce opioid use and improve pain control. We aimed to assess whether this improves pain control and early post-operative complications after ventral hernia repair (VHR). Methods We performed a retrospective study using the Abdominal Core Health Quality Collaborative (2014- 2023) comparing patients with TAP blocks. Primary outcomes included length of stay (LOS) and post-operative pain at 1-, 3-, 6-, and 12 months. Secondary outcomes included 30-day rates of ileus, deep venous thrombosis, pneumonia, and intubations. Results Among 21,608 patients, 1,688 (7.8%) received a TAP block. After matching, TAP block use was associated with a higher rate of "no pain" at 6 months; however, there were no other significant differences in the primary or secondary outcomes, including binary pain scores at any follow-up interval. Conclusion TAP blocks may have some benefit in post-operative pain control for patients with ventral hernias, however further studies are needed.