Clinical trial NCT03890757: Serratus Anterior Plane Block , Paravertebral Block and Quality of Analgesia in Patients With Blunt Chest Trauma
Official title: Efficacy of Serratus Anterior Plane Block Versus Thoracic Paravertebral Block in Patients With Unilateral Multiple Rib Fractures: Comparative Randomized Study
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Analgesia
Lead sponsor: Beni-Suef University
Sponsor class: OTHER
First posted: 2019-03-26
Enrollment: 24
Sex: ALL
Minimum age (years): 20
Maximum age (years): 70
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: CASE_ONLY
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Patients aging from 20 to 70 years old. - ASA physical status status I-II

-- Patients suffering from blunt chest trauma with unilateral multiple rib fractures.

Brief summary: Pain associated with rib movement cause inability to cough and breathe deeply that leads to reduction in the tidal volume and predisposes to significant atelectasis, sputum retention, pneumonia and a reduction in functional residual capacity .These factors in turn lead to decreased lung compliance, ventilation perfusion mismatch, hypoxemia and respiratory distress. Therefore, effective pain relief remains the cornerstone of management to prevent serious respiratory complications .

Detailed description: Thoracic paravertebral block and other regional techniques like intrapleural block and intercostal nerve blocks have variable success and high potential for local anaesthetic toxicity. Serratus anterior plane block is relatively novel technique that is less invasive, easier to perform and improve pulmonary function that reduces the incidence of pneumonia, number of ventilator days, and mortality, especially those sustaining five or more rib fractures

Eligibility criteria: Inclusion Criteria:Patients aging from 20 to 70 years old.

* ASA physical status status I-II -- Patients suffering from blunt chest trauma with unilateral multiple rib fractures.

Exclusion Criteria:• Spinal cord injury.

* Epidural or spinal cord haematoma.
* Thoracic vertebral body fracture.
* Spinal injury awaiting assessment.
* Coagulopathy (platelets \<50×109 litre-1, INR\>1.5).
* Local infection or sepsis.
* Allergy to local anaesthetic.
* Inability to position patient due to associated injuries.
* Severe traumatic brain injury.
* Unstable lumbar or cervical spinal fractures.
* Hypotension.
* Hypovolaemia

Primary outcomes:
measure: The primary outcome of this study was to compare ultrasound guided serratus anterior plane block and ultrasound guided paravertebral block as regard the efficacy of analgesia in patients with blunt chest trauma with unilateral multiple rib fractures
timeFrame: VAS will be recorded before performing the technique , this will be the base line record, then it will be compared by the value of VAS 30 minutes after performing the technique and the value of VAS at 1, 3, 6,12 and 24 hours
Secondary outcomes:
measure: total dose of rescue analgesia
timeFrame: the observation will be for 24 hours
Other outcomes:
Locations:
city: Banī Suwayf
country: Egypt
facility: Beni-Suef University Hospital
Study officials:
affiliation: Assisstant proffesor of anesthesia
name: Samaa Rashwan, MD
role: PRINCIPAL_INVESTIGATOR
References: