This observational study titled Ultrasound guided Rhomboid Intercostal and Subserratus Plane Block as an Analgesic Modality in Acute Rib Fractures aims to evaluate the effectiveness of the Rhomboid Intercostal and Subserratus Plane block for pain relief in patients with multiple rib fractures admitted to the trauma intensive care unit. Rib fractures due to thoracic trauma cause severe pain that limits breathing and increases the risk of respiratory complications such as pneumonia. Although systemic analgesics are commonly used, they may not always provide adequate pain relief.

The study proposes the use of an ultrasound guided Rhomboid Intercostal and Subserratus Plane block as a regional analgesic technique for effective chest wall pain control. The aim is to compare the analgesic efficacy of this block with the standard analgesic protocol used in patients with rib fractures. This technique is expected to reduce pain, improve respiratory function, and decrease the need for systemic opioids.

Adult patients with radiologically confirmed rib fractures will be included in the study after obtaining informed consent. Patients receiving the RISS block will be given an ultrasound guided Rhomboid Intercostal and Subserratus Plane block using 0.25 percent bupivacaine 40 ml followed by catheter placement for continuous analgesia along with standard analgesic treatment. Pain will be assessed using the Numeric Rating Scale at multiple time points up to 48 hours both at rest and during coughing. Respiratory function will be evaluated using incentive spirometry and SpO2 FiO2 ratio and total opioid consumption will also be recorded.

The study involves minimal risk and is expected to show that the RISS block provides better pain relief in patients with acute rib fractures. Improved analgesia may reduce opioid requirement improve incentive spirometry performance enhance respiratory function and contribute to better overall recovery in trauma patient