الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Multiple rib fractures are common among patients sustaining blunt chest trauma. Multiple fractured ribs cause severe pain, which may be more debilitating and harmful than the injury itself. Pain limits patient’s ability to cough and breath deeply, resulting in sputum retention, atelectasis and pneumonia. These factors in turn result in decreased lung compliance, ventilation-perfusion mismatch, hypoxemia, and respiratory insufficiency necessitating assisted ventilation.
Various modalities of analgesia have been used in patients with rib fractures including oral analgesics such as nonsteroidal anti-inflammatory drugs and acetaminophen, intravenous opioids and regional analgesic techniques such as intercostal nerve block, epidural analgesia, intrapleural analgesia and thoracic paravertebral block.
The primary aim of this study was to evaluate the analgesic efficacy of continuous thoracic paravertebral block, continuous interpleural analgesia and parenteral analgesia in adult patients with unilateral multiple traumatic rib fractures and the secondary aim was to assess the effects of the study techniques on the hemodynamics, oxygenation, ventilation, techniques-related complications and failure rate.
This study included 60 adult patients with unilateral multiple traumatic rib fractures (after blunt chest trauma) admitted to the Emergency Medicine Department, Alexandria Main University Hospital (AMUH). Advanced Trauma Life Support (ATLS) protocol was followed for initial assessment and resuscitation.