Continuous Regional Nerve Blocks vs. Thoracic Epidural Block for Rib Fracture Trauma: A Retrospective Cohort Study

Traumatic rib fractures can cause debilitating pain and contribute to morbidity and mortality. Inadequate pain management can increase risk of respiratory complications. Common analgesic techniques include continuous forms of thoracic epidural block (TEB) or regional nerve blocks paired with multimodal analgesia. TEB has been increasingly critiqued for its technical complexity, contraindications, and adverse effects. Continuous regional nerve blocks including the erector spinae serratus anterior plane blocks (ESPB, SAPB) have gained favor as safe and effective alternatives for rib fracture pain. This single site, retrospective cohort study compared the analgesic effectiveness of TEB vs ESPB vs SAPB for rib fracture pain management.