| Description: |
Michael Jiang,1 Varun Peri,1 Bobby Ou Yang,1 Jaewon Chang,2 Douglas Hacking1 1Department of Anaesthesia, Austin Health, Melbourne, Victoria, Australia; 2Department of Surgery, St George Hospital, Sydney, New South Wales, AustraliaCorrespondence: Michael Jiang, Department of Anaesthesia, Austin Health, 145 Studley Road, Heidelberg, 3084, Victoria, Australia, Email Michael.jiang49@gmail.comIntroduction: Rib fractures are a common sequelae of chest trauma and are associated with significant morbidity. The erector spinae nerve block (ESB) has been proposed as an alternative first-line regional technique for rib fractures due to ease of administration and minimal complication profile. We aimed to investigate the current literature surrounding this topic with a focus on pain and respiratory outcomes.Methods: A comprehensive literature search was performed on the Medline, Embase, Web of Science, Scopus, and Cochrane databases. Keywords of “erector spinae block” and “rib fractures” were used to form the search strategy. Papers published in English investigating ESB as an analgesic intervention for acute rib fracture were included. Exclusion criteria were operative rib fixation, or where the indication for ESB was not rib fracture.Results: There were 37 studies which met the inclusion criteria for this scoping review. Of these, 31 studies reported on pain outcomes and demonstrated a 40% decrease in pain scores post administration within the first 24 hours. Respiratory parameters were reported in 8 studies where an increase in incentive spirometry was demonstrated. Respiratory complication was not consistently reported. ESB was associated with minimal complications; only 5 cases of haematoma and infection were (incidence 0.6%) reported, none of which required further intervention.Discussion: Current literature surrounding ESB in rib fracture management provides a positive qualitative evaluation of efficacy and safety. Improvements in pain and respiratory parameters were almost universal. The notable outcome from this ... |