Abstract
We thank A.Houghton for his input on this important topic [ 1 ]. The aim of our exploratory study was to confirm the efficacy and safety of the erector spinae plane block (ESP) and serratus anterior block (SAB) in an effort to guide future research [ 2 ]. We agree that currently there is very little evidence to support the efficacy of one regional anesthesia technique over another for the management of rib fractures. In response to the risks associated with the ESP and SAB, both can result in damage to deeper structures [ 1 , 3 ]. A.Houghton refers to a case of a pneumothorax following the performance of an SAB as a potential indicator of a disparity in safety profiles, favoring the use of an ESP [ 1 ]. However, there has also been a prior report of pneumothorax following an ESP [ 3 ]. Therefore, the decision-making process is not easily determined by efficacy and safety data alone. Additionally, there are many other regional anesthesia options aside from the ESP and SAB. For this reason, we would propose the following as a guide to decision making surrounding the implementation of regional anesthesia for rib fractures.
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