Clinical Scorecard: Comparison of Ultrasound-Guided Erector Spinae Plane Block and Serratus Anterior Plane Block for Pain Relief and Respiratory Function in Patients with Multiple Rib Fractures: A Large-Scale, Single-Center, Randomized, Double-Blind Study

At a Glance

Key Highlights

• ESPB demonstrated significantly lower 24-h pain AUC compared to SAPB (mean difference −17.78, p < 0.001)
• ESPB reduced 24-h opioid consumption and improved QoR-15 scores (both p < 0.01)
• Both groups showed significant within-group improvement in respiratory function parameters
• Safety profiles and complication rates were comparable between ESPB and SAPB
• Analgesic superiority of ESPB was more pronounced in patients with ≤5 fractures

Guideline-Based Recommendations

Diagnosis

• Identify patients with unilateral multiple rib fractures

Management

• Consider ESPB as a first-line regional analgesic technique for better pain control

Monitoring & Follow-up

• Monitor pain scores, opioid consumption, and respiratory function post-intervention

Risks

• Be aware of potential complications associated with rib fractures, such as pneumonia and respiratory failure

Patient & Prescribing Data

158 eligible patients with unilateral multiple rib fractures

0.375% ropivacaine used for both ESPB and SAPB

Clinical Best Practices

• Utilize ultrasound guidance for performing ESPB and SAPB
• Evaluate fracture characteristics to tailor analgesic technique selection
• Implement multimodal analgesia to minimize opioid use

Related Resources & Content

• Chinese Clinical Trial Registry