Background: Pain associated with chest wall trauma is a major issue in the emergency department (ED). However, it may be challenging to select among the various analgesic procedures.
Objective: Our aim was to compare single-shot erector spinae plane block (ESPB) with intercostal nerve block (ICNB) under ultrasound guidance for pain management in thoracic trauma.
Methods: This study was a randomized nonblinded clinical trial performed in a level I urban trauma center. A convenience sample of patients with isolated chest wall trauma and initial Numeric Rating Scale pain scores (NRS 0) > 5 were included. Exclusion criteria were large pain area, surgical interventions, discharged from the ED, and presence of contraindications to lidocaine. Pain scores at 20 min and 60 min (NRS 20 and 60) and at disposition (disp) were recorded.
Results: Twenty-seven patients in the ESPB and 23 in the ICNB groups were enrolled. Mean values of NRS 0, 20, 60, and disp for the ESPB vs. ICNB groups were 8.0 vs. 7.4, 5.2 vs. 6.1, 4.1 vs. 5.4, and 4.3 vs. 5.8, respectively (p = 0.07, p = 0.04, p = 0.001, and p < 0.001, respectively). Four patients in the ESPB and 8 patients in the ICNB groups required administration of adjunctive doses of fentanyl for satisfactory pain control (p = 0.09).
Conclusions: Ultrasound-guided ESPB was superior to ICNB regarding pain control during the ED stay period of patients with painful chest wall trauma. We recommend ESPB in the ED for pain control in blunt or penetrating thoracic trauma.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jemermed.2022.09.018 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Sternal Reconstruction for Refractory Pectus Excavatum From Facioscapulohumeral Muscular Dystrophy.
Ann Thorac Surg Short Rep
December 2024
Department of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.
A 44-year-old man with a history of facioscapulohumeral muscular dystrophy and pectus excavatum presented with multiyear history of progressive, severe respiratory dysfunction, pain, recurrent respiratory infection, and chest wall deformity. With bioprosthetic engineers, the surgical team customized a 3-dimensional printed model of a sternal implant interacting with the patient's anatomy. After approval from the Food and Drug Administration, the customized sternal plates were created and implanted in a sternal reconstruction operation.
View Article and Find Full Text PDFUnderstanding the Mechanisms of Main Bronchial Compression in Patients with Intracardiac Anomalies.
Ann Thorac Surg Short Rep
September 2024
Department of Pediatric Cardiovascular Surgery, Kanazawa Medical University, Ishikawaken, Japan.
Background: The study focuses on vascular compression of the main bronchus in the aortopulmonary space, examining potential contributors within the same axial plane. Its goal is to uncover mechanisms of bronchial compression in patients with intracardiac anomalies and review surgical outcomes, aiming to enhance future results.
Methods: The morphology and topology of structures within the axial plane of the aortopulmonary space were objectively analyzed, including the sternum, ascending aorta, heart, pulmonary artery, descending aorta, and other relevant elements.
Complication Rate of the Nuss Procedure in Adults and Pediatric Patients: National Database Analysis.
Ann Thorac Surg Short Rep
September 2024
Division of Esophageal and Thoracic Surgery, Thomas Jefferson University Hospital, Philadelphia, Philadelphia.
Background: Pectus excavatum (PE) is the most common congenital chest wall defect and is characterized by the inward displacement of the sternum and costal cartilages. To date, there are limited data on adult patients undergoing the Nuss procedure for PE. This study aimed to assess the complication rate between the pediatric and adult populations and assess the trends in demographics.
View Article and Find Full Text PDFRupture of the staple suture site after stapling the right inferior pulmonary vein with double rows of staples: a case report.
Gen Thorac Cardiovasc Surg Cases
January 2025
Department of Surgery II, Faculty of Medicine, Yamagata University, Yamagata, Japan.
Background: With advancements in minimally invasive thoracic surgery techniques, such as video-assisted thoracoscopic surgery and robotic surgery, the design of vascular staplers has evolved to meet the requirements of these procedures. Consequently, newer generations of automatic staplers with improved handling and reduced size have been introduced, such as two-row staplers, which are more maneuverable and less bulky than their three-row counterparts.
Case Presentation: A 68-year-old man with lung cancer underwent a right middle and lower lobectomy due to tumor invasion into the central middle bronchial trunk, rendering the preservation of the middle lobe impossible.
Finite element investigation for improving chest wall reconstruction process using ceramic and polymeric implants.
Sci Rep
January 2025
Biomedical Engineering Department, Faculty of Engineering, Helwan University, Cairo, Egypt.
Car accidents, infections caused by bacteria or viruses, metastatic lesions, tumors, and malignancies are the most frequent causes of chest wall damage, leading to the removal of the affected area. After excision, artificial bone or synthetic materials are used in chest wall reconstruction to restore the skeletal structure of the chest. Chest implants have traditionally been made from metallic materials like titanium alloys due to their biocompatibility and durability.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!