Ultrasound-Guided Mid-Point Transverse Process to Pleura Block Versus Thoracic Paravertebral Block for Pain Management in Patients With Multiple Rib Fractures (A Prospective Randomized Double- Blinded, Non-inferiority Trial )

Inclusion Criteria: * Adult patients aged between 18 and 70 years, from both genders, who had uni lateral traumatic multiple rib fractures (three or more confirmed by a CT chest scan). Exclusion Criteria: * Significant head injury/unconsciousness (GCS less than 15). * Patients with Pain score \>6. * those having significant trauma outside the chest wall, e.g., acute spine or pelvic fracture, severe traumatic brain or spinal cord injury, or abdominal visceral injuries. * Obese patients with body mass index ≥ 35. * coagulopathy. * History of drug allergy to local anesthetics. * Patient refusal. * Local infection at the injection site. * Opioid addiction.