Serratus Anterior Plane Block Versus Thoracic Paravertebral Block.

Ultrasound Guided Serratus Anterior Plane Block Versus Thoracic Paravertebral Block in Emergency Department Rib Fracture

Compare between serratus anterior plane block and thoracic Paravertebral block in analgesia for patients with multiple rib fractures

The study will be conducted in a prospective randomised controlled. Patients will be allocated into three groups

Control group:

The patient will receive fentanyl patch 50 microgram

TPVB group:

The patient will receive thoracic vertebral plane lock 0.4ml/kg bupivacaine 0.1 25% will be administered. For continuous infusion catheter will be inserted . Then a rate of 7ml / hour to max 10 ml / hour of bupivacaine 0.0625%

SAPB group,:

Patient will receive serratus anterior plane block 0.4ml / kg bupivacaine 0.125% will be injected to open the space then a catheter will be advanced For continuous infusion of 0.0625 % bupivacaine at 7 ml / hour

Inclusion Criteria:

• ASA 1_3 Age 18_60 Unilateral fracture ribs

Exclusion Criteria:

• Drug allergy Morbid obese Opioid dependence Patients refuse