RecruitingNot ApplicableNCT05748366

Ultrasound Guided Serratus Anterior Plane Block for Rib Fractures

Ultrasound Guided Serratus Anterior Plane Block Versus Standard Therapy for Analgesic Relief of Rib Fractures in the Emergency Department

Sponsor

WellSpan Health

Enrollment

60 participants

Start Date

Mar 31, 2023

Study Type

INTERVENTIONAL

Conditions

Rib Fracture Multiple

Summary

This study is a single center, randomized controlled trial examining the effect of serratus anterior plane block (SAPB) on pain, PIC scores and other clinical outcomes in emergency department patients with multiple rib fractures in comparison to the use of analgesic medication alone. Objectives 1. Compare SAPB performed in the ED setting to analgesic medication alone with regard to pain, respiratory status and PIC score of patients with multiple rib fractures. 2. Assess the safety and feasibility of performing ultrasound-guided SAPB in the ED. 3. Evaluate outcomes of patients receiving the SAPB in the ED including amount of analgesic medications used, level of care required, need for upgrading level of care, and length of stay.

Eligibility

Min Age: 18 Years

Plain Language Summary

Simplified for easier understanding

This study is testing whether an ultrasound-guided nerve block (called a serratus anterior plane block) provides better pain relief than standard pain medications for patients who have broken ribs. This type of nerve block uses a local anesthetic injected near specific muscles of the chest wall. **You may be eligible if...** - You are over 18 years old - You have more than one rib fracture confirmed by X-ray or CT scan - You are presenting to WellSpan York Hospital emergency department - You need IV pain medication or oral opioids to manage your pain **You may NOT be eligible if...** - You are under 18 - You have an allergy to local anesthetics - You have other major injuries that would also cause pain and make it hard to tell how well the nerve block is working (e.g., broken limbs, internal abdominal injuries) - This is not your first visit for these rib fractures - You are being taken to the operating room urgently or being discharged from the ER Talk to your doctor to see if this trial is right for you.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

PROCEDURESerratus Anterior Plane Block (SAPB)

The ultrasound-guided serratus anterior plane block (SAPB) will be performed in a manner previously described in published medical literature. Patients will be consented and monitored. Bupivacaine 0.5% (5 mg/ml) diluted to 30-40 ml will be used in a dose not to exceed 2 mg/kg. The serratus anterior fascial plane will be identified in the 4th/5th intercostal space. The needle will be advanced under real-time ultrasound guidance targeting the superficial serratus anterior fascial plane. The procedure assistant will inject small volumes to hydrodissect the muscle bellies evenly under direct visualization, indicating local anesthetic spread within the fascial plane. Anesthetic will then be injected in 5 ml increments and the needle will be removed. Patient will be continuously monitored on telemetry and pulse-oximetry. Reassessment of the patient will continue for 30 minutes to monitor for signs of local anesthetic systemic toxicity.

DRUGStandard Analgesic Medications

Analgesic medications will be administered via the intravenous, intramuscular or oral route at the discretion of the medical treatment team.

Locations(1)

Wellspan Health York Hospital

York, Pennsylvania, United States

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