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Please confirm that an ethics committee approval has been applied for or granted: Yes: I’m uploading the Ethics Committee Approval as a PDF file with this abstract submissionBackground and Aims Rib fractures following thoracic trauma are associated with significant morbidity and mortality, often exacerbated by inadequate analgesia impairing respiratory mechanics. Since 2018, Aberdeen Royal Infirmary’s rib fracture service has evolved to offer regional anaesthetic techniques to vulnerable patients.Methods This study reviews patients admitted with radiologically confirmed rib fractures between January and July 2024, focusing on the use of regional blocks, rib fracture scores, complication rates, and 30-day mortality.Results Of the 100 patients included, the median age was 68 years, with 64% male. Rib fracture blocks were administered to 56 patients (56%), who had a higher average rib fracture score (11.63 ± 8.97) compared to those not receiving blocks (8.11 ± 6.04). Block types included 23 (41%) Erector Spinae Plane (ESP), 33 (58%) Serratus Anterior Plane (SAP), and 1 (1%) Parasternal Block. Complications were reported in 7 (21%) of SAP blocks versus 2 (9%) of ESP blocks, primarily due to mechanical or placement issues. The 30-day survival rate was slightly lower in the block group (88%) compared to the non-block group (93%), with the average age of deceased patients being 79.1 years.Conclusions Our data suggests blocks are appropriately targeted at patients with more severe injuries. This reflects global trends shifting from opioid-based to regional analgesia in rib fracture care. However, the higher mechanical complication rate associated with SAP blocks highlights an area for focused training and technique refinement, potentially improving patient outcomes and procedural success.