Opioid Use, Pain Acute, Regional Anesthesia, Rib Fractures
Conditions
Keywords
rib fractures, regional anesthesia, Opioid use, acute pain
Brief summary
The goal of this clinical trial is to test the effectiveness of the Serratus Anterior Plane Block in patients with rib fractures. The main questions it aims to answer are: * Determine if UG-SAPB results in an improved pain, incentive spirometry, and cough ability (PIC) score when compared to usual care over the first five hours. * Evaluate if UG-SAPB results in fewer opioid medications administered when compared to usual care over the first 24 hours. Participants will undergo the Serratus Anterior Plane. Researchers will compare this to usual care to see if this intervention improves pulmonary function and reduces opioid requirements for ED patients with rib fractures.
Interventions
PROCEDURESerratus Anterior Plane Block
Patients who undergo randomization to the intervention arm will undergo the Serratus Anterior Plane Block.
DRUGRopivacaine injection
For the Serratus Anterior Plane Block, Ropivacaine will be used as the anesthetic.
Sponsors
Rhode Island Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
Research Assistants who collect the data will be blinded to which arm of the study the participants are in.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Radiology confirmed anterior or lateral rib fractures either on X-ray or chest computed tomography CT * pain score of 5/10. * Patients must be able to verbalize how much pain they are having on an 11-point Numeric Rating Pain Scale * perform an incentive spirometry and be able to cough on command
Exclusion criteria
* isolated rib fractures that do not include ribs T3-T9 * penetrating trauma, pregnancy * requiring immediate surgical or procedural intervention * known allergy to amide-type local anesthetics * have a painful distracting injury
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| PIC Score | 5 hours | Determine if the SAPB results in an improved pain, incentive spirometry, and cough ability (PIC) score when compared to usual care over the first five hours. The PIC score is a scoring system that can be measured serially in patients with rib fractures to assess pulmonary function and to prognosticate clinical outcomes. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Total oral morphine equivalents over the first 24 hours | 24 hours | Evaluate if UG-SAPB results in fewer opioid medications administered when compared to usual care over the first 24 hours. |
Countries
United States
Outcome results
None listed