Chest Trauma, Chest Pain
Conditions
Brief summary
Patients with ipsilateral multiple rib fractures will be randomized to receive either a single-shot ultrasound-guided serratus plane block, or a continuous serratus plane block within 24h from the chest trauma. Primary outcome is the difference in forced respiratory volume (FEV1) at 72h.
Detailed description
Patients admitted in emergency department with a chest trauma and ipsilateral multiple rib fractures, will be randomized as described above. All patients will receive the serratus block with a ropivacaine 0.37% solution 20 ml. Then, they will randomized to receive either a peripheral catheter placed above the 5th rib on the middle axillary line, or nothing. In all patients postoperative analgesia also include Paracetamol 1g IV each 6h and a patient controlled analgesia (PCA) of morphine set out as follow: bolus 1 mg, loch out 15 min, max 4 boluses each hour. In all patients an arterial blood sample for gas analysis and a FEV1 will be achieved before the block, after 1 hour and at 72h.
Interventions
PROCEDURESerratus plane block
Local anesthetic infusion though a peripheral nerve catheter placed on the 5th rib under the serratus plane
Sponsors
Azienda USL Reggio Emilia - IRCCS
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
* 2 o more ipsilateral rib fractures * Trauma within 24h from hospital admission * Informed consent
Exclusion criteria
* Chest drain * head trauma * bilateral rib fractures * Intensive care admission
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pulmonary change function | day 0 and day 3 | FEV 1 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Numerical rating scale (NRS) of pain | day 0, day 1, day 2, day 3, day 4 | Pain both at rest and on movement on a 0-10 scale where 0 is the best and 10 the worst |
| Morphine | day 0, day 1, day 2, day 3, day 4 | morphine requirement |
| hospital stay | day 1, day 2, day 3, day 4, day 5, day 6, day7 | time to fill the discharge criteria |
Countries
Italy
Outcome results
None listed