A life-saving technique known as chest tube thoracostomy (CTT) facilitates lung re expansion, avoids tension pneumothorax, aids in the healing process following surgery, and relieves symptoms in some types of cancer(1,2).Pneumothorax, hemothorax, chylothorax, empyema, penetrating or severe blunt chest trauma, symptomatic pleural effusion, and chemical pleurodesis for benign and malignant disorders are among the circumstances for which CTT is indicated(3,4,5).But CTT is an extremely painful technique, with over 50% of patients reporting significant pain during or following the surgery(6).The location of the surgical incision, injury to the intercostal nerve, the pleural incision, or the presence of the drainage tubes and the irritation they cause afterwards can all cause pain.

TT is inserted following a regional anesthetic approach. Epidural, paravertebral, muscular plain, intraspinal, intercostal nerve blockage (ICNB), cryo analgaesia, and local administration of anesthetic agents are of presented regional anesthesia for TT insertion .Of these local infiltration anesthesia (LIA) is typically used, either with or without conscious sedation(7,8,9).Although local infiltration is normally safe, its effectiveness is short-lived(10)

A new method to manage patients undergoing CTT’s pain both during and after surgery is fascial plane block (also known as serratus anterior plane block [SPB]). In addition to being useful for treating rib fracture pain and situations requiring the insertion of a chest tube due to anterior and lateral chest wall injuries, SPB was originally developed to give analgesia during breast surgery .It has been demonstrated that SPB is a rather long-lasting localized anesthetic, which enhances incentive spirometry volumes and pain scores(11,12).

While most of the studies are done in a controlled settings like operation theater  this study will compare the SPB and LIA for post procedural analgesia in emergency department where pain management become a key role in managing these patients.