Abstract

Bachground : Rib fractures are seen in more than 50% of patients presenting with blunt chest trauma and are associated with significant morbidity, long-term disability and mortality. More recently, ultrasound-guided fascial plane block techniques, such as the erector spinae plane block and serratus anterior plane block, have emerged as alternatives that are purported to provide excellent analgesia while being simpler and theoretically safer to perform.

Methods: the patients will be allocated into two groups:Group C (control group)

Patients of this group received intravenous paracetamol 1gm/8h plus liometacin amp/12h and

Group E (ESPB group) were undergo erector spinae plane block. .

Results; marked reduction in pain score, prolonged time to 1st analgesic request, lowest rescue fentanyl consumption,decrease cortisol level with better hemodynamic stability , patient satisfaction and less top up doses of fentanyl without any complications related to block technique when compared with patients received normal analgesics.

Conclusion: that ultrasound guided continous erector spinae plane block with bupivacaine (15 ml) resulted in more effective analgesia for multiple ribs fracture with control of stress response.