The Efficacy of Continuous Intercostal Nerve Blocks in the Treatment of Patients With Multiple Rib Fractures
Zachary Warriner
Summary
This is a prospective, randomized, non-blinded study comparing CINB plus medical therapy versus standard medical care (non-steroidals and opioids intravenous/oral inpatient and oral outpatient) alone for patients with multiple rib fractures. The objective of this study is to analyze the effect of continuous intercostal nerve block (CINB) in the treatment of patients admitted to the adult trauma service with rib fractures. The effectiveness of CINB as adjunctive treatment will be compared to standard medical therapy involving nonsteroidal and intravenous/oral opioid medications.
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Subjects will be at least 18 years old * Subjects will have 2 or more identified rib fractures * Subjects will be willing to provide informed consent for procedure * Subjects will be identified as appropriate for initiation of continuous nerve block therapy for treatment of rib fracture associated pain. Exclusion Criteria: * Documented allergy to study medication * Epidural catheter use * Prisoners * Refusal of CINB therapy
Interventions
- DrugRopivacaine
Patients in this group will receive CINB (continuous local intercostal infusion of 0.2% Ropivacaine). A single catheter will be placed for short segment involvement and two catheters will be placed in series for longer segments of involvement. If necessary and as part of standard of care, CINB treatment will continue after patient discharge. The administration of CINB therapy will continue in the same manner as inpatient therapy.
- DrugNon steroidal anti-inflammatory drug and opioids
Patients in this group receive nonsteroidal and opioid pain medications (intravenous/oral inpatient and oral outpatient) per standard of care.
Location
- University of Kentucky Medical CenterLexington, Kentucky