Serratus Anterior Plane Block Versus Thoracic Paravertebral Block.

Study Overview
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Brief Summary
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Compare between serratus anterior plane block and thoracic Paravertebral block in analgesia for patients with multiple rib fractures

Detailed Description
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The study will be conducted in a prospective randomised controlled. Patients will be allocated into three groups Control group: The patient will receive fentanyl patch 50 microgram TPVB group: The patient will receive thoracic vertebral plane lock 0.4ml/kg bupivacaine 0.1 25% will be administered. For continuous infusion catheter will be inserted . Then a rate of 7ml / hour to max 10 ml / hour of bupivacaine 0.0625% SAPB group,: Patient will receive serratus anterior plane block 0.4ml / kg bupivacaine 0.125% will be injected to open the space then a catheter will be advanced For continuous infusion of 0.0625 % bupivacaine at 7 ml / hour

Official Title
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Ultrasound Guided Serratus Anterior Plane Block Versus Thoracic Paravertebral Block in Emergency Department Rib Fracture

Conditions
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Rib Fractures, Analgesia

Intervention / Treatment
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* Procedure: Serratus anterior plane block
* Procedure: Thoracic Paravertebral block
* Procedure: Control


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: ASA 1_3 Age 18_60 Unilateral fracture ribs Exclusion Criteria: Drug allergy Morbid obese Opioid dependence Patients refuse

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Serratus anterior plane block<br>20 patients will receive SAP block with 0.4 ml / kg bupivacaine 0.125% then continuous infusion through a catheter at rate of 7 ml / hour to max 10 ml / hour of bupivacaine 0.0625% | Procedure: Serratus anterior plane block<br>* Injection of bupivacaine between serratus anterior plane and latissimus dorsi muscle using ultrasound<br>|
| Active Comparator: Thoracic Paravertebral block<br>20 patients will receive TPVB 0.4ml / kg bupivacaine 0.125% then continuous infusion through a catheter at rate of 7 ml / hour to max 10 ml / hour of bupivacaine 0.0625% | Procedure: Thoracic Paravertebral block<br>* Injection of bupivacaine in the thoracic Paravertebral space using ultrasound<br>|
| Placebo Comparator: Control group<br>20 patients will receive Fentanyl patch 50 microgram | Procedure: Control<br>* Place a fentanyl patch 50 microgram<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| VAS score | Visual analogue pain score describe by the patient | 24 hour | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Total analgesic consumption | Total opioid consume by the patient in 24 hour | 24 hour | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Fracture rib, TPVB, SAPB