{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T20:02:48Z","timestamp":1769803368286,"version":"3.49.0"},"reference-count":38,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:00:00Z","timestamp":1769644800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Rib fractures cause intense pain, leading to respiratory complications. Standard care relies on systemic opioids, which carry significant adverse effects. The serratus anterior plane block (SAPB) has emerged as a promising regional anesthetic technique, but its efficacy remains unclear. This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to evaluate the efficacy and safety of SAPB versus standard care in patients with rib fractures. Materials and Methods: A comprehensive search of PubMed, Scopus, CENTRAL, and Web of Science was conducted for RCTs comparing SAPB to standard care in adults with rib fractures. The primary outcome was the pain score. Secondary outcomes included 24 h opioid consumption, need for rescue analgesia, and complications. Standardized mean differences (SMD) and risk ratios (RR) were pooled, using STATA SE 19.5. Results: Three RCTs involving 310 patients were included. SAPB significantly decreased pain scores at 2 h (SMD: \u22121.30, 95% CI [\u22122.39, \u22120.20]; p = 0.02), 6 h (SMD: \u22120.75, 95% CI [\u22121.41, \u22120.09]; p = 0.03), 12 h (SMD: \u22120.37, 95% CI [\u22120.68, \u22120.07]; p = 0.02), and 24 h (SMD: \u22125.67, 95% CI [\u22129.90, \u22121.43]; p = 0.01). This was associated with a significant reduction in 24 h opioid consumption (SMD: \u22120.45, 95% CI [\u22120.69, \u22120.21]; p &lt; 0.001). However, no significant differences were found in the need for rescue analgesia (RR: 1.06, 95% CI [0.97, 1.16]; p = 0.18). Conclusions: SAPB provides significant short-term analgesic benefits and reduces opioid consumption in patients with acute rib fractures. While it appears safe, the current evidence is limited by a small number of trials and is insufficient to recommend SAPB as a first-line management option over standard care.<\/jats:p>","DOI":"10.3390\/medicina62020281","type":"journal-article","created":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T08:19:38Z","timestamp":1769761178000},"page":"281","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and Safety of Serratus Anterior Plane Block for Pain Management in Patients with Rib Fractures: A Systematic Review and Meta-Analysis of Randomized Controlled Trials"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-2337-6588","authenticated-orcid":false,"given":"Abdullah M.","family":"Alharran","sequence":"first","affiliation":[{"name":"College of Medicine and Medical Sciences, Arabian Gulf University, Manama P.O. Box 26671, Bahrain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Almutawtah","sequence":"additional","affiliation":[{"name":"Kuwait Institute for Medical Specialization, Kuwait City P.O. Box 1793, Kuwait"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1743-4611","authenticated-orcid":false,"given":"Sarah Saqer","family":"Alblooshi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Al Jahra Hospital, Kuwait City 13001, Kuwait"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fahad A.","family":"Alsaid","sequence":"additional","affiliation":[{"name":"College of Medicine and Medical Sciences, Arabian Gulf University, Manama P.O. Box 26671, Bahrain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad Salem","family":"Alajmi","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sciences, Jordan University of Science and Technology, Amman 22110, Jordan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muneera Jasim","family":"AlRumaihi","sequence":"additional","affiliation":[{"name":"College of Medicine and Medical Sciences, Arabian Gulf University, Manama P.O. Box 26671, Bahrain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara Ahmed","family":"Albuhmaid","sequence":"additional","affiliation":[{"name":"College of Medicine and Medical Sciences, Arabian Gulf University, Manama P.O. Box 26671, Bahrain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1007\/s00068-020-01412-2","article-title":"Epidemiology and outcome of rib fractures: A nationwide study in the Netherlands","volume":"48","author":"Peek","year":"2022","journal-title":"Eur. J. Trauma Emerg. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1177\/08850666221148644","article-title":"Comprehensive Review of Current Pain Management in Rib Fractures with Practical Guidelines for Clinicians","volume":"38","author":"Rogers","year":"2023","journal-title":"J. Intensive Care Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"268","DOI":"10.20408\/jti.2021.0096","article-title":"Outcomes after rib fractures: More complex than a single number","volume":"35","author":"Colling","year":"2022","journal-title":"J. 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