Serratus Anterior Plane Block , Paravertebral Block and Quality of Analgesia in Patients With Blunt Chest Trauma

NCT ID: NCT03890757

Last Updated: 2019-03-26

Basic Information

• Recruitment Status: UNKNOWN
• Total Enrollment: 24 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2019-05-31
• Study Completion Date: 2019-12-31

Brief Summary

Pain associated with rib movement cause inability to cough and breathe deeply that leads to reduction in the tidal volume and predisposes to significant atelectasis, sputum retention, pneumonia and a reduction in functional residual capacity .These factors in turn lead to decreased lung compliance, ventilation perfusion mismatch, hypoxemia and respiratory distress. Therefore, effective pain relief remains the cornerstone of management to prevent serious respiratory complications .

Detailed Description

Thoracic paravertebral block and other regional techniques like intrapleural block and intercostal nerve blocks have variable success and high potential for local anaesthetic toxicity. Serratus anterior plane block is relatively novel technique that is less invasive, easier to perform and improve pulmonary function that reduces the incidence of pneumonia, number of ventilator days, and mortality, especially those sustaining five or more rib fractures

Conditions

Analgesia

Study Design

• Observational Model Type: CASE_ONLY
• Study Time Perspective: PROSPECTIVE

Study Groups

serratus anteriorblock

Serratus plane block will be performed with the patient in the lateral position and the arm abducted. Using a high-frequency linear ultrasound probe

ultrasound guided paravertebral or serratus anterior block

Intervention Type: OTHER

Patients groups will be as follow:

Group (I): Serratus plane block will be performed with the patient in the lateral position and the arm abducted. Using a high-frequency linear ultrasound probe ,Group (II): thoracic paravertebral block will be performed in the sitting position. The spinal level chosen for needle insertion will be two segments below the upper most fractured rib or midway between the upper most and lowest fractured rib, 2-2.5 cm distance from the midline in the same injury site

Interventions

ultrasound guided paravertebral or serratus anterior block

Patients groups will be as follow:

Group (I): Serratus plane block will be performed with the patient in the lateral position and the arm abducted. Using a high-frequency linear ultrasound probe ,Group (II): thoracic paravertebral block will be performed in the sitting position. The spinal level chosen for needle insertion will be two segments below the upper most fractured rib or midway between the upper most and lowest fractured rib, 2-2.5 cm distance from the midline in the same injury site

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• ASA physical status status I-II -- Patients suffering from blunt chest trauma with unilateral multiple rib fractures.

Exclusion Criteria

• Epidural or spinal cord haematoma.
• Thoracic vertebral body fracture.
• Spinal injury awaiting assessment.
• Coagulopathy (platelets <50×109 litre-1, INR>1.5).
• Local infection or sepsis.
• Allergy to local anaesthetic.
• Inability to position patient due to associated injuries.
• Severe traumatic brain injury.
• Unstable lumbar or cervical spinal fractures.
• Hypotension.
• Hypovolaemia

• Minimum Eligible Age: 20 Years
• Maximum Eligible Age: 70 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Samaa Rashwan

OTHER

Sponsor Role: lead

Responsible Party

Samaa Rashwan

Samaa Abou Alkassem Rashwan

Responsibility Role: SPONSOR_INVESTIGATOR

Principal Investigators

Samaa Rashwan, MD

Role: PRINCIPAL_INVESTIGATOR

Assisstant proffesor of anesthesia

Locations

Beni-Suef University Hospital

Banī Suwayf, , Egypt

Site Status: RECRUITING

Countries

Egypt

Central Contacts

Samaa A Rashwan, MD

Role: CONTACT

samakassemrashwan@gmail.com

020120159125

Facility Contacts

Samaa Rashwan, MD

Role: primary

0201270159125

Other Identifiers

Beni-Suef University Hospital

Identifier Type: -

Identifier Source: org_study_id