US-guided SAPB for Rib Fractures in the ED
| Status: | Recruiting |
|---|---|
| Conditions: | Orthopedic |
| Therapuetic Areas: | Orthopedics / Podiatry |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 12/20/2018 |
| Start Date: | November 6, 2018 |
| End Date: | August 31, 2019 |
| Contact: | Andrew Herring |
| Email: | aherring@alamedahealthsystem.org |
| Phone: | 510-633-7498 |
Ultrasound-guided (US) Serratus Anterior Plane Block (SAPB) for Acute Rib Fractures in the Emergency Department (ED)
The purpose of this randomized controlled study is to determine whether the serratus anterior
plane block reduces pain more than the usual treatment for rib fractures in the same amount
of time.
plane block reduces pain more than the usual treatment for rib fractures in the same amount
of time.
Patients with unilateral rib fractures in the Highland Hospital Emergency Department who
agree to participate will be randomized 1:1 to either the control group or the experimental
group. Those in the control group will receive the usual oral and/or IV pain medication as
needed. The experimental group will receive an ultrasound-guided serratus anterior plane
block. Numerical pain rating scale scores at rest and when taking a deep breath will be
recorded pre-intervention and at times 0, 20, 40, and 60. At time 60, patients who received
the SAPB will receive sensory testing. Patients will be offered additional pain medication as
needed at times 20, 40, and 60.
agree to participate will be randomized 1:1 to either the control group or the experimental
group. Those in the control group will receive the usual oral and/or IV pain medication as
needed. The experimental group will receive an ultrasound-guided serratus anterior plane
block. Numerical pain rating scale scores at rest and when taking a deep breath will be
recorded pre-intervention and at times 0, 20, 40, and 60. At time 60, patients who received
the SAPB will receive sensory testing. Patients will be offered additional pain medication as
needed at times 20, 40, and 60.
Inclusion Criteria:
- Males and females 18 years and older, capable of providing informed consent indicating
awareness of the investigational nature of the study, in keeping with institutional
policy.
- Written informed consent must be obtained from each patient prior to entering the
study.
- Patients with moderate to severe pain (NRS 4 to 10) as a result of one or more rib
fractures occurring at levels T2-T8, measured on a self-reported NRS.
Exclusion Criteria:
- Patient refusal
- Patients with significant pain from other injuries (as determined at the discretion of
the treating physician)
- Patients deemed critically ill by provider
- Patients with decompensated psychiatric disorders
- Pregnant patients (positive urine or serum B-HCG)
- History of heart block or bradycardia
- History of uncontrolled seizures
- Patients allergic to lidocaine, bupivacaine, ropivacaine, or morphine
- Patients with bilateral rib fractures
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