The Analgesic Effect of Retro-laminar Block Versus Paravertebral Block in Patients With Multiple Fracture Ribs

Rib fractures are a common injury, occurring in up to 10% of all trauma patients. Multiple rib fractures can be particularly painful and debilitating, making it difficult for patients to breathe and cough. This can lead to complications such as atelectasis, pneumonia, and respiratory failure. Adequate pain control is essential for patients with rib fractures. This can help to improve respiratory function, reduce the risk of complications, and speed up recovery. Paravertebral block (PVB) is a regional anaesthetic technique that is commonly used for pain management in patients with rib fractures. It involves injecting local anaesthetics into the paravertebral space, which is a region of tissue located between the transverse processes of the vertebrae and the pleura. PVB is an effective way to block the sensory nerves that supply the thoracic region, including the ribs. However, PVB can be technically challenging to perform, and there is a risk of complications such as pneumothorax and pleural puncture. Retrolaminar block (RLB) is a newer regional anaesthetic technique that has been proposed as an alternative to PVB for pain management in patients with rib fractures. RLB involves injecting local anaesthetics into the retrolaminar space, which is a region of tissue located between the lamina of the vertebra and the epidural space. RLB is thought to be easier to perform than PVB, and there is a lower risk of complications. However, there is limited studies support the use of RLB for pain management in patients with rib fractures. The primary objective of this research is to compare the analgesic efficacy of retrolaminar block (RLB) and paravertebral block (PVB) in patients with fracture ribs. Secondary objectives include: * To compare the safety of RLB and PVB * To compare the duration of analgesia provided by RLB and PVB

Inclusion Criteria: * \* Age 18 years or older * American Society of Anesthesiologists (ASA) physical status I-III * Rib fractures, as confirmed by X-ray or computed tomography (CT) scan * Both sexes, males and females. Exclusion Criteria: * \*Patient refusal. * Infection at the injection site * Allergy to local anesthetics * Neurological deficit * Spinal deformity