Background and Aims Erector spinae plane block is a relatively novel approach to pain management for a variety of surgical procedures, as well as for acute and chronic pain¹. It is performed as a single injection block, or a catheter is placed for continued relief, and the procedure is most often performed with ultrasound guidance. Multiple rib fracture requires early intervention with adequate pain relief to prevent potential chest infection and prolonged hospital stay and, regional anaesthetic techniques are often a crucial component in analgesia.

Methods A 41-year-old female was admitted through A&E with Bilateral multiple rib fractures. The patient was trampled by a cow and sustained multiple injuries. Her CT scan reported clear lungs, with no pneumothorax or haemothorax. There were displaced rib fractures on the right side namely anterior 2nd and 3rd, antero-lateral 6th, postero-lateral 8th and 11th. Displaced rib fractures on the right side were anterior 3–6th ribs and postero-lateral 12th rib. Apart from this left clavicle fracture was fractured on medial one-third, T12 -L2 spinous process fracture, T12-L4 right transverse process fractures with significant displacement. Additionally, comminuted nasal bone fractures were reported. Bilateral erector spinae block and placement of catheter was performed under ultrasound guidance.

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Abstract B242 Figure 1

ResultsPCM- Paracetamol OM- Oramorph

Conclusions Chest wall injuries are associated with significant morbidity and mortality, especially in patients with coexisting respiratory disease². Thoracic epidural, thoracic paravertebral, and intercostal blocks are available for the pain relief options, each has unique advantages and disadvantages. In our institution Erecter spinae block and catheters are offered along with other options.