Ultrasound- Guided Continuous Serratus Anterior Plane Block Versus Ultrasound- Guided Continuous Thoracic Paravertebral Block in Multiple Traumatic Rib Fractures.
- Conditions
- Thoracic Paravertebral BlockMultiple Traumatic Rib FracturesUltrasoundSerratus Anterior Plane BlockAnalgesia
- Interventions
- Procedure: Thoracic paravertebral blockProcedure: Serratus anterior plane block
- Registration Number
- NCT04710823
- Lead Sponsor
- Tanta University
- Brief Summary
The aim of this study is to compare the analgesic efficacy of ultrasound guided continuous SAP block and ultrasound guided continuous TPVB in patients with multiple traumatic rib fractures.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 70
- Patients of either gender aged between 22-65 years with unilateral traumatic multiple fracture ribs (≥ 3 fractured ribs).
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• Contraindications to regional block such as patient's refusal, coagulopathy, local infection at the site of the block, known allergy to local anesthetic drugs and spinal deformity.
- Patients suffer from severe cardiovascular disease, hepatic or renal disease and patients with history of psychiatric illness.
- Patients had indications for mechanical ventilation on admission or during the study period.
- Patients had indications for immediate surgery for other associated injuries.
- Patients with hemodynamic instability.
- Patients having spine or pelvic fracture, traumatic brain injury, altered conscious level or spinal cord injury.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Thoracic paravertebral block Thoracic paravertebral block Patients will receive ultrasound-guided continuous thoracic paravertebral blockusing bupivacaine 0.25% for 4 days. Serratus anterior plane block Serratus anterior plane block Patients will receive ultrasound-guided continuous SAP block using bupivacaine 0.25% for 4 days.
- Primary Outcome Measures
Name Time Method Degree of pain scores Four days after the block Pain will be assessed at rest and on coughing using the VAS on a scale from 0 (no pain) to 100 (worst pain) before the block, 30 minutes, 60 minutes after the block, and then every six hours for 4 days. But in order not to interrupt the sleeping pattern of patients, patients will be considered pain free (VAS= 0) if they will be at sleep with no tachypnea, tachycardia, or hypertension.
- Secondary Outcome Measures
Name Time Method Changes of forced vital capacity (FVC) Four days after the block Forced vital capacity (FVC) will be assessed using bedside spirometry before the block, 30 minutes, 60 minutes after the blocks, and then every eight hours for 4 days
Changes of forced expiratory volume in one second (FEV1) Four days after the block Forced expiratory volume in one second (FEV1) will be assessed using bedside spirometry before the block, 30 minutes, 60 minutes after the blocks, and then every eight hours for 4 days
Incidence of complications Four days after the block Incidence of respiratory complications and mechanical ventilation
Total consumption of morphine Four days after the block Rescue analgesia will be provided with morphine (0.05 mg/kg) intravenously if visual analogue score (VAS) ≥ 40.
Changes of forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) Four days after the block FEV1/FVC ratio will be assessed using bedside spirometry before the block, 30 minutes, 60 minutes after the blocks, and then every eight hours for 4 days
Length of ICU stay Four days after the block Length of ICU stay, defined as the time from admission to ICU to time of transfer to the surgical ward.
Length of hospital stay Four days after the block
Trial Locations
- Locations (1)
Tanta University Hospitals
🇪🇬Tanta, ElGharbiaa, Egypt