SERRATUS ANTERIOR PLANE BLOCK FOR MULTIPLE RIB FRACTURES-A NOVEL PAIN MANAGEMENT TECHNIQUE

Context: Rib fractures are mostly traumatic. Commonly seen in patients suffering from multiple injuries due to road traffic accidents or fall from height, conventional treatment is with intravenous/oral analgesics or opioid patches. The innervation of the ribs passes through the Serratus Anterior Plane and hence we aim to administer anaesthetic in this plane to achieve reliable and quality pain relief. Methods and materials: 20 patients presenting with a rating of 8 on the visual analogue scale, whose pain was not relieved by intravenous analgesics and showed signs of rapid shallow breathing were administered SAPB unilaterally using ultrasound guidance. Results: The patients pre-block median pain scores were 60 minutes Post block the median pain scores were. There were no complications due to the block the 24-hour post block period was uneventful. Conclusions: Patients with multiple rib fractures (MRF) can be treated with SAPB with very good results and should be tried when patients are in severe pain not responding to intravenous anaesthetics and with deterioration of pulmonary function.