Abdominal field blocks in minimally invasive surgery and the cutaneous sensory block area

We read with great interest the randomized trial by George et al,1 which enhances our understanding of the quadratus lumborum (QL) and transversus abdominis plane (TAP) blocks in colorectal surgery. The study provides valuable insights into the dermatomal coverage of both blocks using a lateral ultrasound-guided approach. The primary outcome—assessing the number of dermatomes above L1 with reduced cold sensation—was complemented by the 24-hour postoperative opioid-equivalent consumption as a secondary outcome. Dermatomal mapping was performed using sensation to ice along a vertical mid-clavicular line, demonstrating that the QL block resulted in more extensive and reliable sensory deprivation than the TAP block. However, this broader sensory block did not correspond to reductions in opioid consumption or pain scores.