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.
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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
100
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. The block will be performed close, by considering the level of rib fractures.
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. The block will be performed close, by considering the level of rib fractures.
Emiliano
L’Aquila, L'Aquila, Italy
Pain intensity
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"
Time frame: First 72 hours from the block
Diaphragmatic motion
The percentage of diaphragmatic thickening measured as thickness at end-inspiration-thickness at end-expiration divided by thickness at end-expiration
Time frame: First 72 hours from the block
Arterial blood gas analysis
Fraction of inspired oxygen to partial pressure of oxygen ratio
Time frame: First 72 hours from the block
Airflow rate
Patient airflow rate measured in mL/second, by using an incentive spirometer with three balls
Time frame: First 72 hours from the block
Blood pressure
Invasive blood pressure (systolic and diastolic pressure in mmHg)
Time frame: First 72 hours from the block
Sensory 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.
Time frame: First 72 hours from the block
Request of analgesic drugs
Consumption of analgesic drugs (equivalent mg of morphine)
Time frame: First 72 hours from the block
Anesthetic spread
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Thoracic paravertebral space spread (yes or no), evaluated with ultrasonography
Time frame: First 72 hours from the block
Complication
Number of pneumothorax, hemothorax, hematoma, pain, infection, and neurological impairment by the block
Time frame: First 72 hours from the block