A Comparative study of Analgesic Efficacy between Ultrasound Guided Continuous Erector Spinae Plane Block versus Continuous Thoracic Paravertebral Block in Patients with Unilateral Fracture Ribs

Background and aim: Inadequate control of rib fracture-associated pain can establish devastating hypoventilation, lung atelectasis and pneumonia. The traditional analgesic models proved sub-optimal efficacy with considerable consequences. Consequently, this study aimed to demonstrate analgesia of utilizing ultrasound-guided intermittent injection of erector spinae plane block with a fixed catheter against intermittent injection of thoracic paravertebral block with a fixed catheter for pain alleviation in patients with unilateral rib fractures. Methods: This trial was carried out on 70 unilateral rib fracture cases. Cases were classified randomly into 2 equivalent groups. Group A (n = 35) received an ultrasound-guided erector spinae plane block with a fixed catheter. Group B (n = 35) received an ultrasound-guided thoracic paravertebral block with a fixed catheter. Hemodynamics, analgesia parameters and complications were assessed at a predefined time-points. Results: This study documented non-significant distinction among the groups, concerning time to first analgesia inquiry, total dose and frequency of cases required analgesia. Inter-group comparison demonstrated a non-significant distinction regarding VAS score at rest and on cough. Nevertheless, intra-group comparison revealed a significant reduction in VAS score after the procedure when contrasted with baseline values (p value <0.05). Tachypnea was significantly relieved in the two groups within 30 minutes after the procedure. Conclusion: Ultrasound-guided erector spinae plane block is equally effective as thoracic paravertebral block in providing pain relief for patients with unilateral multiple fractured ribs. Conversely, complications were less frequently associated with erector spinae plane block.