Comparison of Continuous Intravenous Lidocaine Infusion Versus ESP Block for Rib Fracture Analgesia
Status:
Not yet recruiting
Trial end date:
2022-07-30
Target enrollment:
Participant gender:
Summary
Recently in 2016, a new interfascial plane nerve block was developed for thoracic analgesia
known as the erector spinae plane block (ESPB). Since its development for thoracic
neuropathic pain, the ESPB has been shown to be effective in pain control in multiple
procedures including thoracotomies. However, there have been a few published case reports of
using ESPB for analgesia in rib fracture management and only one retrospective study which
demonstrated improved NRS pain scores and increased incentive spirometry volumes (ICV)
post-ESPB compared to pre-ESPB values.
The goal of this study is to compare the effectiveness of ESPB as an alternative method to
the current standard of care at Stanford Health Care (SHC) for pain management in traumatic
rib fractures. At the investigator's institution, the current standard of care is intravenous
(IV) and enteral multimodal analgesia that consists primarily of opioids and a continuous IV
lidocaine infusion. Although IV lidocaine has shown some benefit in improving post-surgical
pain scores, evidence for its use in MRF is lacking. The purpose of this study is to perform
a randomized clinical trial comparing outcomes in pain control and incentive spirometry
volumes between continuous ESPB catheters and IV lidocaine infusions in adult patients with
acute traumatic rib fractures.
The investigators want to determine if ESPB can provide improved pain control in patients
admitted for traumatic rib fractures compared to IV Lidocaine. The aim is to evaluate the
clinical effectiveness of ESPB on OME consumption, pain scores, incentive spirometry volumes,
cough strength, respiratory complications, inflammatory biomarkers and hospital LOS. Findings
from this study can help improve analgesia, quality of care, and patient satisfaction at
Stanford Healthcare and for other acute pain and trauma surgery providers.
The aim of this study involves pain management for patients with acute traumatic rib
fractures and therefore must involve human subjects.