Comparative Study between Efficacy of Serratus Anterior Muscle Block as A Regional Analgesia Technique and I.V Morphine Infusion in Patient with Fracture Ribs

Abstract

Background: Rib fractures are very common and are detected in at least 10% of all injured patients, the majority of which are because of blunt thoracic trauma with road traffic collisions being the main cause. Pain management of the acutely injured patient with rib fractures can be difficult for even the most experienced emergency physician. Objective: To evaluate the safety and efficacy of serratus anterior muscle plane block as a regional analgesic technique performed in patient with fracture ribs. Patients and Methods: Randomized, controlled study was carried out in Department of Anesthesia and Intensive Care Unit, Sohag University Hospital. Forty patients with lateral multiple rib fractures were included in this study. All patients were suffering from excruciating pain and were not responding to conventional analgesics. The patients were randomly assigned into two groups, 20 patients each. Group A, for whom serratus anterior plane block (SAP) was done and Group B, for IV morphine infusion. Results: In Group A, the mean pain score decreased from 9.1 ± 0.7 to 0.6 ± 0.7 after intervention. In group B, the mean pain score improved from 9.3 ± 0.8 to 1.15 ± 0.8 after IV morphine infusion. Pain scores gradually decreased. There were no significant difference between the two groups when the other trauma surveys were compared. Conclusion: Ultrasound guided Serratus Anterior Plane block is an effective technique for providing analgesia in patients with anterior and lateral rib fractures with fewer risks of complications.