الفهرس 
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Abstract
This prospective randomized controlled study was done in the ED of Minia University hospital between November 2018 to April 2021 on 60 patients of both sexes who suffered from unilateral multiple rib fracture, aged between 18 to 65 years and with ASA physical status below I-III.
The study aimed to evaluate and compare the efficacy and safety of ultrasound guided thoracic paravertebral block (TPV) and serratus anterior plane block (SAP) in fracture ribs patients.
The patients were categorized into three equal groups:
group F (Transdermal Fentanyl Patch): (20patients)
Patients of this group received transdermal fentanyl patch 50mcg.
group P (TPVB group): (20patients)
Patients in this group received thoracic paravertebral block. Patients were given 5-7 ml of bupivacaine 0.125% to open the space then continuous infusion was initiated at a rate of 7ml/hour to max.10ml/hour of bupivacaine 0.0625%.
group S (SAPB group): (20patients)
Patients in this group had serratus anterior plane block. A 0.4 ml/kg of bupivacaine 0.125% was injected to open the layer then continuous infusion of 0.0625% bupivacaine was commenced at 7ml/hour to 10ml/hour.
In case of breakthrough pain, intravenous fentanyl (0.1-0.2mcg/kg) was given as a rescue drug.
All patients were assessed in terms of the following:
- Hemodynamic variables as heart rate (beats/min) and mean arterial blood pressure (mmHg).
- Respiratory parameters (Oxygen saturation and respiratory rate).
- Visual analogue pain score (at rest and dynamic).
- Time to first analgesic request and total analgesic requirement.
- Incidence of any complications.
Our results showed that patients in all groups were hemodynamically stable.
The study showed that group (P) and (S) had significant lower VAS readings, longer time for first analgesic request and less total analgesic consumption in 24 hours than (F) group, with no significant difference could be detected between (P) & (S) groups.