An elusive truth: does the mechanism of action of the ESP block really matter for rib fractures?

We congratulate Luchsinger et al 1 on their interesting and well-conducted cadaveric study investigating further the mechanism of action of the erector spinae plane (ESP) block. Several mechanisms of action have previously been proposed for this block,2 and while of academic interest, we question the clinical relevance, particularly regarding rib fracture analgesia.