Rib Fractures, Serratus Anterior Plane Block, Erector Spinae Plane Block, Acute Pain
Conditions
Keywords
Rib Fractures, Serratus Anterior Plane Block, Erector Spinae Plane Block
Brief summary
More than 50% of patients presenting with chest trauma experience rib fractures and these rib fractures are associated with significant morbidity, mortality, and long-term disability. Many of these adverse outcomes result from poorly controlled pain that interferes with breathing, leading to atelectasis, pneumonia, and respiratory failure. Therefore, early provision of adequate analgesia is crucial in the management of these patients. The basic stones of analgesic therapy are oral and intravenous drugs such as paracetamol, nonsteroidal anti-inflammatory drugs (NSAIDs), and opioids. However, patients with more significant injuries or comorbidities often require interventional procedures to provide adequate analgesia and avoid opioid-related side effects. Thoracic epidural analgesia and thoracic paravertebral blocks have traditionally been used, but these techniques are associated with side effects and may cause hemodynamic instability. Today, the use of ultrasonography (USG) guided block techniques such as erector spinae plane block (ESPB), serratus anterior plane block (SAPB) and intercostal block (ICB) has increased. These techniques are considered to be simpler and theoretically safer. Although ICB is frequently mentioned in the literature, the publications of new plane blocks such as ESPB and SAPB are new and few in number. In this study, SAPB and ICP to be performed with USG will be evaluated in terms of analgesic effect.
Interventions
PROCEDURESerratus Anterior Plane Block
Serratus anterior plane block will be performed unilaterally, under US guidance.
PROCEDUREIntercostal Block
Intercostal Block will be performed unilaterally, under US guidance.
Sponsors
Atatürk Chest Diseases and Chest Surgery Training and Research Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Age between 18 and 65 years * American Society of Anesthesiologists physical status I-II-III * Body mass index between 18-30 kg/m2 * Patients with 6 or less rib fractures
Exclusion criteria
* Patient refusing the procedure * History of chronic analgesic or opioid therapy * History of local anesthetic allergy * Infection in the intervention area
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pain scores | 24 hours after block | Pain will be assessed at rest and while coughing using the visual analog scale on a scale from 0 (no pain) to 10 (worst pain). Pain assessment will be done at 1st, 2nd, 4th, 8th, 16th and 24th hours after surgery. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Need for additional analgesia | 24 hours after block | Whether the patients need additional analgesia after the block and the amount of additional analgesia needed will be recorded. |
Countries
Turkey (Türkiye)
Outcome results
None listed