Management of Unilateral Fracture Ribs using Ultrasound Guided Erector Spinae Plane Block versus Paravertebral Block

Background: For many different purposes, paravertebral plane block (PVB) has been the favoured regional anaesthesia treatment for postoperative analgesia. The initial definition of erector spinae plane (ESP) block was as a new analgesic technique for thoracic neuropathic pain.
Objective: To improve pain management in patients with fracture ribs through setting regional blocks as a protocol at Suez Canal University Hospitals.
Patients and methods: This study included 70 patients with unilateral multiple rib fracture. They were divided into two groups: Group (E) patients who received ultrasound-guided ESP block with 20 ml of bupivacaine 0.25% as a loading dose and group (p) patients who received ultrasound-guided PVB block with 20 ml of bupivacaine 0.25% as a loading dose.
Results: Age, sex, weight, and the number of fractured ribs between the two groups did not differ statistically. There was a significantly lower TLC in the E group at 48 h compared to the P group as well as the baseline value. In both groups, there was a significantly lower neutrophil count at 24 h and 48 h compared to the respective baseline value. In group P, there was a significantly higher lymphocyte count at 24 h compared to the baseline value. Moreover, there was a significantly higher lymphocyte count at 48 h compared to the baseline value in both groups.
Conclusion: Both continuous ESPB and TPVB can be used for pain control of unilateral multiple fracture ribs.