Purpose of review Abdominal wall blocks in adults have evolved much during the last decade; that is, particularly with the introduction of ultrasound-guided (USG) blocks. This review highlights recent advances of block techniques within this field and proposes directions for future research. 

Recent findings Ultrasound guidance is now considered the golden standard for abdominal wall blocks in adults, even though some landmark-based blocks are still being investigated. The efficiency of USG transversus abdominis plane blocks in relation to many surgical procedures involving the abdominal wall is the most common nerve block effect measurement investigated in goal-directed research. The advent of the various quadratus lumborum block techniques with a long-lasting analgesic effect have opened up a new area of research, and the use of liposomal bupivacaine for transversus abdominis plane blocks have been introduced with success. Future research should also investigate the effect of specific abdominal wall blocks on neuroendocrine and inflammatory stress response after surgery. 

Summary USG abdominal wall blocks in adults are commonplace techniques today. Most abdominal wall blocks are assigned evidence grade A or B according to the US Agency for Healthcare Policy and Research guidelines.