الفهرس 
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Abstract
Rib fractures are the most common thoracic blunt trauma injury. They are a common cause of hospital admission and are associated with significant morbidity and mortality. The key element to prevent post-fracture complications is optimal analgesia.
There has been growing interest in the Erector Spinae Plane block (ESPB) for the management of rib fractures. The ESP block has been reported to provide effective analgesia with minimal complications, however its efficacy compared to other analgesic options is poorly understood.
The aim of the study was to compare the effect of ESP block and opioid based analgesia in pain control in patients with multiple rib fractures.
This study was conducted on 52 randomly chosen patients in Ain Shams university hospitals after approval of the medical ethical committee. They were allocated in two groups of 26 patients each:
group A: Patients received US guided ESPB with 20 ml of bupivacaine 0.25%.
group B: Patients received IV morphine 0.1 mg/kg then were provided with IV PCA device of 100 ml volume containing morphine 40 mg and normal saline at a rate of 2ml/h.
The two groups were compared regarding analgesic outcome using VAS score measured at rest and after spirometer exercise. Also Peak Inspiratory Flow Rate (PIFR) was measured by incentive spirometer, calculation of the first 12 hours morphine consumption as rescue analgesia and rate of complications were recorded, and patients satisfaction was assessed.
The results of the study revealed that Erector Spinae Plane Block provided superior analgesia and improved respiratory function for IV PCA morphine. Furthermore, ESPB was safe and associated with less opioid use, and better patient satisfaction.