. 2023 Jun 12;16:81–90. doi: 10.2147/LRA.S414056

Table 1.

Summary of Key Findings in the Prospective and Retrospective Cohort Studies

Study	Study Design	Number of Patients	Number of Rib Fractures	Block Type	Indication for Block	Main Findings
Adhikary et al 2019⁷	Retrospective cohort study	79	23 less than 5 41 between 5–7 14 more than 7	Ropivacaine 0.5% with adrenaline single shot Ropivacaine 0.2% 6–10mL/hr infusion	Analgesic intervention for patients admitted with rib fracture	39% improvement in pain score post block Reduction in opioid requirement and improved spirometry did not meet statistical significance
Dultz et al 2021⁴⁰	Retrospective cohort study	25	3 between 1–4 15 between 5–8 7 more than 8	Ropivacaine 0.5% 20–100mL single shot Ropivacaine 0.2% 4–12mL/hr infusion	Routine intervention for patients with rib fracture	Fewer missed doses of anticoagulation compared to thoracic epidural No patients with bleeding complication in ESB group
El Malla et al 2022⁴⁴	RCT vs serratus anterior block	25 (ESB) 25 (SAB)	Median (IQR) 5 (4-6) ESB 5 (3.5–6) SAB	Bupivacaine 0.25% 19mL with 4mg dexamethasone single shot	First day of ICU admission for trauma	Statistically significant reduction in pain scores post ESB compared to SAB Lower median tramadol consumption in ESB group Statistically significant improvement in diaphragmatic excursion from 2hrs post ESB compared to SAB
Elawamy et al 2022⁴⁵	RCT vs thoracic paravertebral block	30 (ESB) 30 (TPB)	Mean ± SD 4.43±1.10 (ESB) 4.73±1.28 (TPB)	Bupivacaine 0.5% 0.3mL/kg with 8mg dexamethasone single shot	Analgesic intervention for rib fractures	Comparable opioid requirement between groups No statistically significant difference in pain score after 30mins between groups 11 complications in TPB group compared to 0 in ESB group
Mladenovic et al 2022⁴¹	Retrospective cohort study	199	Mean ± SD 6.48±2.5 (prompt) 6.07±2.5 (early) 5.96±2.8 (late)	Ropivacaine 0.2–0.375% 15–30mL load, ropivacaine 0.2% 10–20mL bolus Q1-3H	Analgesic intervention for rib fractures	ESB within 48hrs of admission reduces respiratory complication and ICU length of stay compared to block post 48 hrs
Murray et al 2022⁴²	Retrospective matched case-control study vs TPB	17 (ESB) 17 (TPB)	Mean ± SD 6.5±1.5 (ESB) 6.7±1.6 (TPB)	Ropivacaine 0.2% infusion	Analgesic intervention for rib fracture	46% reduction in pain score in ESB group, no statistically significant difference to TPB group
Palachick et al 2022⁴⁶	Prospective interventional study	45	Mean 6.8	RECK solution (ropivacaine 123mg, adrenaline 0.25mg, clonidine 0.04mg, ketorolac 15mg)	Offered as analgesic intervention to rib fracture patients	Reduced pain score and improved spirometry volumes which were statistically significant improvements from pre block values
White et al 2022⁴³	Retrospective cohort study	224	Mean ± SD 6.1±2.7	Ropivacaine 0.2–0.375% 15–30mL load, ropivacaine 0.2% 10–20mL bolus Q1-3H	Analgesic intervention for rib fractures	Complications of haematoma (N=2) and infection (N=2) without need for intervention Over a quarter of patients had contraindication to paravertebral block or thoracic epidural.