MODERN METHODS OF PAIN RELIEF FOR PATIENTS WITH MULTIPLE RIB FRACTURES (OWN EXPERIENCE)

Objectives To assess the effect of thoracic paravertebral block (PVB) on pain management and preservation of pulmonary function compared with intravenous, patient-controlled analgesia (IVPCA) in patients with multiple rib fractures (MRFs). Methods Ninety patients with unilateral MRFs were included in this prospective study and randomly assigned to the TPVB or IVPCA group. The visual analogue scale (VAS) pain score, blood gas analysis, and bedside spirometry were measured and recorded at different time points after analgesia. Results TPVB and IVPCA provided good pain relief. VAS scores were significantly lower in the TPVB group than in the IVPCA group at rest and during coughing ( P < 0.05). Patients in the TPVB group had a higher PaO2 and PaO2/FiO2 and lower P(A–a)O2 compared with the IVPCA group ( P < 0.05). Moreover, patients in the TPVB group showed higher FVC, FEV1/FVC, and PEFR, and fewer complications than did the IVPCA group ( P < 0.05). Conclusion TPVB is superior to IVPCA in pain relief and preservation of pulmonary function in patients with MRFs.

Download Full-text

Serratus anterior block for pain relief in multiple rib fractures: Case report (serratus anterior block in multiple rib fractures)

Serbian Journal of Anesthesia and Intensive Therapy ◽

10.5937/sjait1904081i ◽

2019 ◽

Vol 41 (3-4) ◽

pp. 81-85

Author(s):

Nataša Ilić ◽

Radomir Ilić

Keyword(s):

Case Report ◽

Pain Relief ◽

Rib Fractures ◽

Serratus Anterior ◽

Multiple Rib Fractures

Download Full-text

Erector Spinae Plane Fascial Block in Multiple Rib Fractures (Case Report)

General Reanimatology ◽

10.15360/1813-9779-2020-5-22-29 ◽

2020 ◽

Vol 16 (5) ◽

pp. 22-29

Author(s):

V. Kh. Sharipova ◽

I. V. Fokin ◽

F. K. Sattarova ◽

F. O. Parpibayev

Keyword(s):

Pain Relief ◽

Pain Intensity ◽

Local Anesthetic ◽

Pain Perception ◽

Rib Fractures ◽

Erector Spinae ◽

Thoracic Vertebrae ◽

Multiple Rib Fractures ◽

Catheter Tip ◽

Item Scale

The aim of the study: to improve the efficacy of erector spinae plane (ESP) fascial block for pain management in patients with multiple rib fractures. Materials and methods. We observed 4 patients with multiple rib fractures who were treated with ESP fascial block with subsequent prolonged administration of local anesthetic for pain relief. To evaluate the efficacy of the ESP block, the visual analogue scale (VAS) for pain intensity, cough performance index and forced vital capacity (FVC), as well as a modified 3-item scale were used. The distribution of local anesthetic (10% lidocaine solution) and contrast (iohexol solution, 350 mg iodine/ml) media was analyzed by computed tomography and correlated with the data on reduced pain perception according to the thoracic vertebrae (Th) levels.Results. After the ESP block in patients with multiple rib fractures, we found a decrease in VAS pain intensity at rest by 3-4 points and on coughing by 3-6 points, an increase in cough performance by 1 point and in the modified 3-item scale by 1-3 points. The distribution of the local anesthetic solution was registered mainly in the cranial-caudal and anterior direction to the intertransversal space without significant leakage in lateral and medial directions. In all 4 cases the local anesthetic and contrast media spread from the catheter tip cranially several levels of thoracic vertebrae farther than in caudal direction.Conclusion. ESP block in patients with multiple rib fractures is a reasonably effective method of pain relief. Catheterization of the fascial plane of erector spinae muscle should be performed at the level of vertebra corresponding to the underlying fractured rib. The data obtained may serve as a basis for further studies with more patients included.

Download Full-text