{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:31:01Z","timestamp":1787761861121,"version":"build-2784847793"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Aims:<\/jats:title>\n                    <jats:p>Pain contributes to flail chest morbidities. The aim of this study was to compare the analgesic effects of ultrasound-guided erector spinae plane block (ESPB) with thoracic epidural analgesia (TEA) in patients with traumatic flail chest.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods:<\/jats:title>\n                    <jats:p>\n                      Sixty patients aged 18 \u2013 60 years, ASA I-II, with unilateral flail chest were allocated into TEA group with a loading dose of 6 ml bupivacaine 0.25% and 2 \u03bcg\/ml fentanyl and ESPB group with a loading dose of 20 ml bupivacaine 0.25% and 2 \u03bcg\/ml fentanyl. This was followed by continuous infusion of 6 ml\/hour bupivacaine 0.125% and 2 \u03bcg\/ml fentanyl in both groups for 4 days. Pain scores at rest and on coughing, rescue analgesic consumption, PaO\n                      <jats:sub>2<\/jats:sub>\n                      \/FIO\n                      <jats:sub>2<\/jats:sub>\n                      ratio, PaCO\n                      <jats:sub>2<\/jats:sub>\n                      , pulmonary functions and adverse events were recorded.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      In both groups, Visual Analog Scale (VAS) scores at rest and on coughing were significantly decreased after block initiation as compared to pre-block value. At all-time points, VAS scores at rest and on coughing were insignificantly different between both groups. PaO\n                      <jats:sub>2<\/jats:sub>\n                      \/FIO\n                      <jats:sub>2<\/jats:sub>\n                      ratio, forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) were significantly increased and respiratory rate, PaCO\n                      <jats:sub>2<\/jats:sub>\n                      , were significantly decreased as compared to pre-block values of the same group without significant difference between both groups. The incidence of hypotension was significantly higher in TEA group than ESPB group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>ESPB can achieve adequate analgesia in traumatic flail chest equivalent to that of TEA with significant improvement of arterial oxygenation and pulmonary functions and without serious adverse effects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/joacp.joacp_416_21","type":"journal-article","created":{"date-parts":[[2023,5,11]],"date-time":"2023-05-11T22:01:20Z","timestamp":1683842480000},"page":"250-257","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":14,"title":["Ultrasound guided erector spinae plane block versus thoracic epidural analgesia in traumatic flail chest, a prospective randomized 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