Patients with ipsilateral multiple rib fractures will be randomized to receive either a single-shot ultrasound-guided serratus plane block, or a continuous serratus plane block within 24h from the chest trauma. Primary outcome is the difference in forced respiratory volume (FEV1) at 72h.
Patients admitted in emergency department with a chest trauma and ipsilateral multiple rib fractures, will be randomized as described above. All patients will receive the serratus block with a ropivacaine 0.37% solution 20 ml. Then, they will randomized to receive either a peripheral catheter placed above the 5th rib on the middle axillary line, or nothing. In all patients postoperative analgesia also include Paracetamol 1g IV each 6h and a patient controlled analgesia (PCA) of morphine set out as follow: bolus 1 mg, loch out 15 min, max 4 boluses each hour. In all patients an arterial blood sample for gas analysis and a FEV1 will be achieved before the block, after 1 hour and at 72h.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Local anesthetic infusion though a peripheral nerve catheter placed on the 5th rib under the serratus plane
AUSL IRCCS Reggio Emilia
Reggio Emilia, Italy
Pulmonary change function
FEV 1
Time frame: day 0 and day 3
Numerical rating scale (NRS) of pain
Pain both at rest and on movement on a 0-10 scale where 0 is the best and 10 the worst
Time frame: day 0, day 1, day 2, day 3, day 4
Morphine
morphine requirement
Time frame: day 0, day 1, day 2, day 3, day 4
hospital stay
time to fill the discharge criteria
Time frame: day 1, day 2, day 3, day 4, day 5, day 6, day7
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