Continuous posterior extrathoracic fascial plane block versus continuous paravertebral block for pain management in patients with multiple rib fractures: a randomised controlled noninferiority trial
Authors' conclusion
Posterior extrathroacic fascial plane block promoted a noninferior effect on morphine consumption at 24 h compared with paravertebral block in patients with multiple rib fractures.
Study context
- Population
- Trauma patients with multiple rib fractures not mechanically ventilated77.7% male
- Participants
- 90 patients
- Comparison
- Continuous PEFB vs continuous paravertebral block (PVB) vs systemic analgesia
- Primary endpoint
- Morphine consumption
- Follow-up
- 24 h
Methodological detailsnoninferiority, three-arm
- Noninferiority
- Three-arm
Primary result
As reported in the abstract
Morphine consumption at 24 h
P < 0.001
Secondary outcomes
Morphine consumption at 72 h (per-protocol) · per-protocol analysis
| Outcome | PEFB | PVB | Control | β (95% CI) | P value |
|---|---|---|---|---|---|
| Rescue thoracic epidural analgesiaPEFB vs PVB · across groups | Thirty percent | 6.7% | Thirty percent | P = 0.043 | |
| MEP over 72 hHigher values in PVB | 12.71 (2.73–22.77) | P = 0.012 |
- Morphine consumption at 72 h (per-protocol) — Higher in control; no significant difference between intervention groups
- P=0.051
Pain scores during coughing
- Higher during coughing in all groups (β)
- 3.89
- Lower with significant interaction in PVB (β)
- −0.58
- P<0.0001 for coughing; P=0.010 for PVB interaction
SNIP over 72 h
- Increased significantly from baseline in all groups (β)
- 7.2 to 14.9
- P=0.002
Original publication
Continuous posterior extrathoracic fascial plane block versus continuous paravertebral block for pain management in patients with multiple rib fractures: a randomised controlled noninferiority trial. Br J Anaesth. Published 20 November 2025. doi:10.
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