Dexmedotomidine for Acute Pain Control in Patients With Multiple Rib FracturesRandomized Controlled Trial
Status:
Recruiting
Trial end date:
2024-06-30
Target enrollment:
Participant gender:
Summary
Blunt chest trauma is the second most common form of unintentional trauma in the US and is
associated with significant morbidity and mortality. Thoracic injuries are the third most
common cause of death in trauma patients. Rib fractures have an increased associated risk of
pneumonia, prolonged hospitalization, and cost. The associated severe pain leads to poor
pulmonary mechanics, which contributes to additional complications. Treatment for rib
fractures is focused on optimizing analgesia and intense pulmonary hygiene. Most common
strategies utilize early mobilization, incentive spirometry (IS), and multimodal pain
regimens.
A variety of techniques for analgesia after blunt chest trauma exist. Epidural analgesia is
one of the best-studied methods and can often provide significant pain relief. However, this
method is invasive, has associated complications, and often can be contraindicated due to
coagulopathy or other injuries. Most often a form of multimodal pain strategy is utilized
which incorporates acetaminophen, Nonsteroidal anti-inflammatory drugs (NSAIDs), trans-dermal
lidocaine, and muscle relaxants. Opioids remain an important adjunct to control severe pain,
however, narcotics have their own associated complications.
The aim of our study is to use an infusion of dexmedetomidine (Precedex) to aid in pain
management in patients presenting with 3 or more rib fractures. The investigators hypothesize
that dexmedetomidine will decrease patient pain and opioid use.