Clinical trial NCT06299137: Ultrasound Guided Serratus Anterior Plane Block in ED Patients With Rib Fractures
Official title: Ultrasound Guided Serratus Anterior Plane Block in ED Patients With Rib Fractures,
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: EARLY_PHASE1
Conditions: Rib Fractures
Pain Acute
Regional Anesthesia
Opioid Use
Keywords: rib fractures
regional anesthesia
Opioid use
acute pain
Lead sponsor: Rhode Island Hospital
Sponsor class: OTHER
First posted: 2024-03-07
Enrollment: 40
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The goal of this clinical trial is to test the effectiveness of the Serratus Anterior Plane Block in patients with rib fractures. The main questions it aims to answer are:

* Determine if UG-SAPB results in an improved pain, incentive spirometry, and cough ability (PIC) score when compared to usual care over the first five hours.
* Evaluate if UG-SAPB results in fewer opioid medications administered when compared to usual care over the first 24 hours.

Participants will undergo the Serratus Anterior Plane. Researchers will compare this to usual care to see if this intervention improves pulmonary function and reduces opioid requirements for ED patients with rib fractures.


Eligibility criteria: Inclusion Criteria:

* Radiology confirmed anterior or lateral rib fractures either on X-ray or chest computed tomography CT
* pain score of 5/10.
* Patients must be able to verbalize how much pain they are having on an 11-point Numeric Rating Pain Scale
* perform an incentive spirometry and be able to cough on command

Exclusion Criteria:

* isolated rib fractures that do not include ribs T3-T9
* penetrating trauma, pregnancy
* requiring immediate surgical or procedural intervention
* known allergy to amide-type local anesthetics
* have a painful distracting injury

Primary outcomes:
measure: PIC Score
timeFrame: 5 hours
Secondary outcomes:
measure: Total oral morphine equivalents over the first 24 hours
timeFrame: 24 hours
Other outcomes:
Locations:
city: Providence
country: United States
facility: Rhode Island Hospital
state: Rhode Island
Study officials:
References:
citation: Paul S, Bhoi SK, Sinha TP, Kumar G. Ultrasound-Guided Serratus Anterior Plane Block for Rib Fracture-Associated Pain Management in Emergency Department. J Emerg Trauma Shock. 2020 Jul-Sep;13(3):208-212. doi: 10.4103/JETS.JETS_155_19. Epub 2020 Sep 18.
citation: Kring RM, Mackenzie DC, Wilson CN, Rappold JF, Strout TD, Croft PE. Ultrasound-Guided Serratus Anterior Plane Block (SAPB) Improves Pain Control in Patients With Rib Fractures. J Ultrasound Med. 2022 Nov;41(11):2695-2701. doi: 10.1002/jum.15953. Epub 2022 Feb 2.
citation: Lin J, Hoffman T, Badashova K, Motov S, Haines L. Serratus Anterior Plane Block in the Emergency Department: A Case Series. Clin Pract Cases Emerg Med. 2020 Jan 21;4(1):21-25. doi: 10.5811/cpcem.2019.11.44946. eCollection 2020 Feb.
citation: Thiruvenkatarajan V, Cruz Eng H, Adhikary SD. An update on regional analgesia for rib fractures. Curr Opin Anaesthesiol. 2018 Oct;31(5):601-607. doi: 10.1097/ACO.0000000000000637.
citation: Sarode AL, Ho VP, Pieracci FM, Moorman ML, Towe CW. The financial burden of rib fractures: National estimates 2007 to 2016. Injury. 2021 Aug;52(8):2180-2187. doi: 10.1016/j.injury.2021.05.027. Epub 2021 May 19.