add on intercostal nerve block to relieve pain in patients with blunt chest trauma blunt chest trauma , intercostal nerve block , multimodal analgesis
Conditions
Interventions
multimodal analgesia consist of
1. paracetamol
2. NSAIDs
3. TCA : amitriptylene
4. Gabapentinoids : gabapentin
5. muslce relaxant : mydocalm,0.5% bupivacaine add on multimodal analgesia
*we compare
Experimental Drug,Experimental Drug
multimodal analgesia,intercostal nerve block
Sponsors
None listed
Eligibility
Sex/Gender
All
Age
18 Years to 79 Years
Inclusion criteria
Inclusion criteria: 1. blunt traumatic chest trauma patients were registered in Maharaj Nakorn Ratchasima hospital 2.Age 18-79 years old with diagnosis of rib fracture with or without pneumohemothorax 3. Chest trauma score more than 6 point and pain score more than 7 point 4. injury occurs less than 48 hr.
Exclusion criteria
Exclusion criteria: 1. unstable vital signs with inotropic or vasopressor drug 2. proved intraabdominal injury 3. morbid obesity BMI > 35 4. Moderate to severe traumatic brain injury (GSC < 13) 5. Onset of injury > 72hr. 6. Major bone fracture e.g. pelvic fracture , femur fracture, both bone of leg 7. Intubated patients on arrival/ before admission 8. pregnancy or breast feeding 9. Immuno-compromised host HIV with opportunistic infection or CD4 count < 200 cells/cu.mm Autoimmune disease with steroid use 10. Heart or great vessel injury 11. Cervical or thoracic spine injury with loss of sensation 12. Anticoagulation or antiplatelet used
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| pain score 3 month verbal pain score and facial pain scale | — |
Secondary
| Measure | Time frame |
|---|---|
| pulmonary complication 3 month clinical and investigation,pneumonia 3 months clinical and investigation,ARDS 3 month clinical and investigation,require intubation 3 month clinical and investigation,lung ateletasis 3 month clinical and investigation,pulmonart embolism 3 month clinical and investigation,duration of chest tune drain 3 month clinical and investigation,lenght of ICU/hospital stay 3 month clinical and investigation,30 day mortality and complication from procedure e.g hemothorax,pneumothorax,he,hematoma 3 month clinical and investigation | — |
Countries
Thailand
Contacts
Public ContactPISIT SABANGBAN
Maharat Nakorn ratchasima hospital
Outcome results
None listed