This is an observational study which will evaluate the efficacy of the serratus anterior plane block for treating pain and respiratory capacity in patients with multiple rib fractures. When resources are available for a SAPB to be performed, patients will receive this block in addition to traditional pain medications, while at other times, patients will receive traditional pain medications only.
Pain management by systemic analgesics and by nerve blocks are both standard of care and used in Emergency Department (ED) depending on the resources available. Not all ED physicians are trained or comfortable with the serratus anterior nerve block and thus it is not always available to patients and is provider dependent. This is an observational study where patients with multiple rib fractures will receive either a serratus anterior plane block (SAPB) in addition to traditional forms of pain control when providers trained to perform the block are available, or will receive traditional forms pain control if trained personnel are not available. In addition to the serratus anterior plane block, standard forms of pain control in the Stanford Emergency Department include: oral or parenteral acetaminophen, oral or parenteral NSAIDs, oral or parenteral opiates, parenteral lidocaine, and parenteral ketamine. Retrospective evaluation of the allocation of patients to either nerve block or no nerve block will be dictated by physician ability, time and resources to do the block. The efficacy of the block will be evaluated by serial measurements of pain score and respiratory capacity.
Study Type
OBSERVATIONAL
Enrollment
39
Injection of bupivacaine 75mg above the serratus anterior facial plane in the anterior axillary line
Stanford University Hospital
Palo Alto, California, United States
Change in pain score
Patient reported pain score from 0-10 (0 - no pain, 10 = worst pain imaginable).
Time frame: Before and 3 hours after analgesia administration
Change in incentive spirometry volume
Maximum inspiratory respiratory volume (measured in ml) recorded on single use of incentive spirometer device
Time frame: Before and 3 hours after analgesia administration
Analgesia administration
Dosage of analgesic medications administered for pain during ED visit and hospital stay
Time frame: Up to 3 days
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