Mid-point to Pleura Transverse Process Block Versus Thoracic Intervertebral Foramen Block
- Conditions
- Pain, AcuteRib FracturesPolytrauma
- Interventions
- Procedure: Thoracic intervertebral foramen blockProcedure: Mid-point to pleura transverse process block
- Registration Number
- NCT05348330
- Lead Sponsor
- San Salvatore Hospital of L'Aquila
- Brief Summary
The analgesic effect of continuous mid-point to pleura transverse process block compared to the analgesic effect of continuous thoracic intervertebral foramen block, in patients with multiple rib fractures.
- Detailed Description
The analgesic effect of continuous mid-point to pleura transverse process block will be compared to the analgesic effect of continuous thoracic intervertebral foramen block, in patients with multiple rib fractures, by using the numeric rating scale (NRS) for pain.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 100
- ribs fracture after polytrauma
- pregnancy
- allergy to anesthetics
- head trauma
- history of neurological impairment (primary or secondary)
- history of cancer
- history of chronic obstructive pulmonary disease
- infections of skin close to the block site
- systemic infections
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Thoracic intervertebral foramen block Thoracic intervertebral foramen block Under ultrasound guidance the continuous thoracic intervertebral foramen block, will be provided to achieve analgesia in polytraumatic patients with rib fractures. A set for continuous peripheral nerve block will be used. The infusion rate of analgesic solution (levobupivacaine 0.25% combined with dexamethasone 16 mg) will be titrated to patient perceived pain. Mid-point to pleura transverse process block Mid-point to pleura transverse process block Under ultrasound guidance the continuous mid-point to pleura transverse process block, will be provided to achieve analgesia in polytraumatic patients with rib fractures. A set for continuous peripheral nerve block will be used. The infusion rate of analgesic solution (levobupivacaine 0.25% combined with dexamethasone 16 mg) will be titrated to patient perceived pain.
- Primary Outcome Measures
Name Time Method Pain intensity First 72 hours from the block The 11-point numeric scale ranges from '0' representing one pain extreme (e.g. "no pain") to '10' representing the other pain extreme (e.g. "pain as bad as you can imagine" or "worst pain imaginable"
- Secondary Outcome Measures
Name Time Method Sensory block First 72 hours from the block Response to the stimulus (yes or no), by using a piece of cotton, and ice in a finger of surgical glove on the patient's skin.
Blood pressure First 72 hours from the block Invasive blood pressure (systolic and diastolic pressure in mmHg)
Request of analgesic drugs First 72 hours from the block Consumption of analgesic drugs (equivalent mg of morphine)
Anesthetic spread First 72 hours from the block Thoracic paravertebral space spread (yes or no), evaluated with ultrasonography
Complication First 72 hours from the block Number of pneumothorax, hemothorax, hematoma, pain, infection, and neurological impairment by the block
Arterial blood gas analysis First 72 hours from the block Fraction of inspired oxygen to partial pressure of oxygen ratio
Airflow rate First 72 hours from the block Patient airflow rate measured in mL/second, by using an incentive spirometer with three balls
Diaphragmatic motion First 72 hours from the block The percentage of diaphragmatic thickening measured as thickness at end-inspiration-thickness at end-expiration divided by thickness at end-expiration
Trial Locations
- Locations (1)
Emiliano
🇮🇹L'Aquila, Italy