Acute pain management of patients with multiple fractured ribs.

Multiple rib fracture causes severe pain that can seriously compromise respiratory mechanics and exacerbate underlying lung injury and pre-existing respiratory disease, predisposing to respiratory failure.

The cornerstone of management is early institution of effective pain relief.
Analgesia could be provided using systemic opioids or non steroidal anti-inflammatory drugs. Alternatively, regional analgesic techniques such as intercostal nerve block, epidural analgesia, intrathecal opioids, interpleural analgesia and thoracic paravertebral block have been used effectively.
Although invasive, in general, regional blocks tend to be more effective than systemic opioids, and produce less systemic side effects.

By understanding the strengths and weaknesses of each analgesic technique, the clinician can weigh the risks and benefits and individualize pain management based on the clinical setting and the extent of trauma.