Continuous Intercostal Nerve Blockade for Traumatic Rib Fractures

• Status: Terminated
• Trial end date: 2016-11-01
• Target enrollment: 0
• Participant gender: All

Summary

Rib fractures are common injuries in accident patients and can be associated with significant pain during recovery. If poorly controlled, pain from splinting due to rib fractures can result in difficulty in breathing leading to incomplete expansion of lung, and even the need to put a patient on a ventilator to help them breathe. Therefore, pain control is critical in managing patients with rib fractures. To date, many studies have shown the effectiveness of continuous intercostal nerve blockade (a slow release of pain medications at the site of injury that prevents the transmission of pain signals). This approach has never been studied in a randomized fashion in rib fracture patients, and has never been compared to patient-controlled narcotic pain medication, commonly used at many hospitals. The purpose of this study is to evaluate the effectiveness of the placement of an elastomeric infusion pump (a small, external, wearable balloon used to deliver medication over time) attached to a continuous infusion catheter or "soaker" catheter (a tube which releases the pain medication through tiny holes in it, right at the site of injury) to deliver local anesthetic medication to reduce pain caused by two or more rib fractures.

• Phase: N/A
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Anthony Iacco
• Collaborator: William Beaumont Hospitals
• Treatments: Bupivacaine; Hydromorphone

Criteria

Inclusion Criteria:

• Admission to trauma service at Beaumont Hospital, Royal Oak, Michigan

• Two or more rib fractures in an anatomic pattern feasible for nerve blockade (unilateral or bilateral)

• Age greater than or equal to 18 years

• Ability to comprehend and endorse an informed consent

Exclusion Criteria:

• Patients who are pregnant or breastfeeding

• Patients intubated before placement of continuous infusion catheter

• Any significant concomitant injuries potentially confounding for evaluation of the effectiveness of analgesia (eg., traumatic brain injury)

• History of an allergic reaction to local anesthetic

• Use of other regional anesthetics before evaluation (epidural or paravertebral nerve blockade)

• International Normalized Ratio (INR) > 2.0

• Inability to obtain informed consent