Ultrasound Guided Rhomboid Intercostal Block for Myofascial Pain Syndrome

Study Overview
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Brief Summary
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Rhomboid intercostal block (RIB) is an interfacial plane block described in 2016. It creates analgesia at T2-T9 levels in the hemithorax by applying local anesthetic to the fascia between the rhomboid muscle and the intercostal muscle. It has been used effectively in patients with chronic pain. Recently published report has shown that rhomboid intercostal block (RIB) may provide effective pain control for myofascial pain syndrome (MPS), too. MPS is a regional pain syndrome characterized by trigger points detected in one or more regional muscle groups. The investigators planned a prospective observational study, a total of 30 patients who will apply to our clinic with MPS, will register in research. The investigators will perform ultrasound-guided RIB, and evaluate the clinical outcomes.

Detailed Description
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Myofascial pain syndrome (MPS) is the most common cause of musculoskeletal pain and its prevalence in the population is reported to be 21-30%. Rhomboid intercostal block (RIB) is an interfacial plane block described in 2016. It creates analgesia at T2-T9 levels in the hemithorax by applying local anesthetic to the fascia between the rhomboid muscle and the intercostal muscle. It has been used effectively in patients with chronic pain. The investigators planned a prospective observational study.From february to march 10 2021, a total of 30 patients who will apply to our clinic with MPS, will register in research. The investigators will perform ultrasound-guided RIB, and evaluate the clinical outcome Ultrasound guided RIB will applied with linear probe, in plane technique. Block needle was inserted to plane between the rhomboid muscle and intercostal muscles over the T5-6 ribs 2 cm to 3 cm medially from the medial border of the scapula. 13ml of bupivacaine 0.25% and 8mg dexamethasone mixture will inject into the fascial plane. Numerical Rating Scale (NRS) will recorded before and after the block at 30 minutes, day 1, 1-2-4-6 weeks.

Official Title
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Ultrasound Guided Rhomboid Intercostal Block for Myofascial Pain Syndrome: Observational Study

Conditions
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Myofascial Pain Syndrome

Intervention / Treatment
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* Other: ultrasound guided rhomboid intercostal block


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Complaint of myofascial pain Pain that is rated at least 3 on a numerical rating scale (NRS, 0 = no pain, 10 = the worst pain) Exclusion Criteria: pregnancy the presence of coagulopathy, or the use of anticoagulants a history of surgery on the block area allergic to bupivacaine decline to participate

Ages Eligible for Study
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Minimum Age: 18 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: Supportive Care
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: block group<br>ultrasound guided rhomboid intercostal block will performed | Other: ultrasound guided rhomboid intercostal block<br>* A linear ultrasound probe was medially placed in the sagittal plane on the medial border of the scapula at the T5-T7 level. We inserted a 22-gauge needle into the fascial plane between the rhomboid major and intercostal muscles in a craniocaudal direction and injected 15 ml mixture of 0.25% bupivacaine with 8 mg of dexamethasone into the fascial plane.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Numerical Rating Scale (NRS) Pain Score Change | The 11-point NRS consists of numbers between 0 and 10 where 0 indicates no pain and 10 indicates maximum pain. The patient is instructed to identify one number between 0 and 10, which is best representative of their pain intensity. | Change from baseline to minutes 30, day 1, week 1, 2, 4, 6 after the block | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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rhomboid intercostal block, ultrasound guided block