Serratus plane block and erector spinae plane block in the management of pain associated with rib fractures in chest trauma: a brief report from a single-center

Abstract

Pain harms the clinical course of individuals with rib fractures. Patients with more than three fractured ribs are more likely to have lung problems because pain can impede lung ventilation and secretion clearance due to difficulty coughing, resulting in atelectasis and hypoxia. Systemic analgesia to invasive regional anesthesia procedures such as thoracic epidural, paravertebral catheters, intercostal nerve blocks, and fascial plane blocks are all alternatives for analgesia in chest trauma. The study’s goal is to evaluate the analgesic efficacy of erector spinae plane (ESP) and serratus anterior plane (SAP) blocks in chest injuries, as well as their effect on improving respiratory metrics. For this objective, fifteen cases of isolated thoracic trauma resulting in rib fractures were reviewed retrospectively. All patients were at least 18 years old, spontaneously breathing, and had received a chest wall fascial plane block for pain relief. All patients reported practically instantaneous pain alleviation, with the onset occurring around 10 minutes after the block operation. One patient required oxygen therapy, but the rest were quickly weaned due to improved respiratory mechanics. Our findings suggest that chest wall anesthetic blocks are a safe and effective therapy for pain caused by rib fractures. At admission, the median NRS was 7 (RF 6:26.7%; 7:26.7%; 8:26.7%; 9:13.3%; 10:6.7%), with a minimum of 6 and a maximum of 10 (IQR: 1.5, CV: 0.2). All patients reported immediate pain relief that began around 10 minutes after the block was done; the average decrease in NRS was 6.8 points. They have also been shown to be effective and beneficial in improving respiratory parameters and lowering oxygen support.

Keywords

• Pain
• chest
• trauma
• rib fracture
• block
• serratus