Pain management in older adults with trauma is often under-recognized. Rib fractures are a common injury that can cause severe pain and are associated with increased morbidity and mortality if left untreated or inadequately managed. Opioids remain the standard treatment for severe pain
Conditions
Interventions
Group receiving SAPB
The researcher prepared medication for SAPB (stored in the double-lock system drawer in the emergency room). The drug dosage was 1 mg per kilogram body weight of 0.5 percents bupi
Serratus anterior plane block,Morphine intravenous
Sponsors
Navamindradhiraj University Research Fund
Eligibility
Sex/Gender
All
Age
65 Years to No maximum
Inclusion criteria
Inclusion criteria: Age more than or equal 65 years old. Presented with Rib fracture. Pain score numeric rating scale more than or equal 5.
Exclusion criteria
Exclusion criteria: Patients need immediate intervention. Patients need acute rescue for STEMI, Stroke, and Aortic dissection. Skin infection at the fracture side. Trauma more than 2 organ. Chronic Kidney Disease stage 5 or eGFR less than 15 ml/mins Take anticoagulants and INR more than 1.7 Cirrhosis child B to C Actual body weight more than 90 kg. History of opioid used within 4 hours. History of alcohol or drug abuse. History of morphine, bupivacaine or fentanyl allergy. Patients with difficulty to communication (e.g. altered mental status, severe dementia (define by 6-items cognitive screening more than 12), language barrier).
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| A reduction of pain score at 30 minutes 30 minutes Verbal numeric rating scale | — |
Secondary
| Measure | Time frame |
|---|---|
| a reduction of pain score 1 hr, 2 hr,4 hr, 6 hr, 12 hr and 24 hr Verbal numeric rating scale ,Adverse events 1 hr, 2 hr, 4 hr, 6 hr , 12 hr, 24 hr Dizziness, Vertigo, hypotension, desaturation,Rescue therapy 30 minutes Give fentanyl 1 microgram per kilogram if the pain does not improve less than 3 ,pulmonary function Initial, 2 hr Spirometry measurement | — |
Countries
Thailand
Contacts
Public ContactJiraporn Srion
Vajira Hospital, Navamindradhiraj University
Outcome results
None listed