Comparing epidural block and intercostal block in patients with 3–4 broken ribs following chest cage blunt trauma

Introduction: Pain in trauma patients with injuries due to rib fractures and chest trauma is one of the primary goals of management. Through various methods including oral medications, intravenous and intramuscular and different techniques of regional analgesia such as block intercostal, par vertebral block, and epidural block are performed. This study aimed to compare the efficacy of epidural block and block intercostal among patients with rib fractures. Methods: This study was a randomized, double-blind clinical trial involving 82 patients with fractures of the ribs 4-3 visit to Valiasr Hospital, and no pneumothorax as well as hemothorax was carried out. They were randomly divided into two groups of 41 people intercostal block and epidural blocks. In the first group in the thoracic epidural block, using the Marcaine 0.25% 0.3 cc/kg was given. In the second group, posterior dose 0.2 cc/kg Marcaine 0.25% block was given through intercostal. Results: The mean pain score (vascular-space-occupancy, the pain before surgery) was not significantly different between the two groups with respect to P ≥ 0.05. However, compared to the pain in 15 min, 1 h, 2 h, 12 h, and 24 h after block was significantly different between the two groups, according to P ≤ 0.01 and the pain was lower in the epidural block. In terms of age, sex, and chest X-ray changes, there was no significant difference between the two groups (P ≥ 0.05). Conclusion: The results of our study showed the effectiveness of thoracic epidural block in patients with 3–4 intercostals rib fracture which results in blunt trauma.