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Indian J Anaesth. 2018 Feb;62(2):139-141. doi: 10.4103/ija.IJA_599_17.

Erector spinae plane block may aid weaning from mechanical ventilation in patients with multiple rib fractures: Case report of two cases.

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Department of Anaesthesia, Kovai Medical Center and Hospital, Coimbatore, Tamil Nadu, India.


Uncontrolled pain in patients with rib fracture leads to atelectasis and impaired cough which can progress to pneumonia and respiratory failure necessitating mechanical ventilation. Of the various pain modalities, regional anaesthesia (epidural and paravertebral) is better than systemic and oral analgesics. The erector spinae plane block (ESPB) is a new modality in the armamentarium for the management of pain in multiple rib fractures, which is simple to perform and without major complications. We report a case series where ESPB helped in weaning the patients from mechanical ventilation. Further randomised controlled studies are warranted in comparing their efficacy in relation to other regional anaesthetic techniques.


Analgesia; erector spinae plane block; rib fracture; ventilation

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