Continuous Bilateral Serratus Anterior Plane Block: An Effective Analgesic Strategy for Managing Extensive Bilateral Rib Fractures.

Patients with multiple bilateral rib fractures frequently experience intense pain and limited thoracic mobility, leading to complications such as reduced coughing efficiency, pulmonary infection, and respiratory failure. While thoracic epidural analgesia is often considered the gold standard for pain management in these cases, its use is limited by contraindications and the need for patient positioning that exposes the back. The serratus anterior plane block, guided by ultrasound, offers a promising alternative for managing thoracic pain, particularly for polytrauma patients who cannot sit up or assume lateral positions required for traditional regional blocks. This case report describes a patient admitted to the intensive care unit following a fall that caused multiple bilateral rib fractures. Due to contraindications for epidural analgesia related to coagulopathy, bilateral serratus anterior plane blocks were performed with catheter placement on each side, providing effective pain relief and improving respiratory function.