Ultrasound Guided Emergency Physician Performed Erector Spinae Nerve Block for Rib Fracture Analgesia

• Status: Not yet recruiting
• Trial end date: 2022-12-15
• Target enrollment: 0
• Participant gender: All

Summary

The study will be a prospective randomized double blinded placebo controlled clinical trial using ultrasound guided erector spinae plane block as an analgesic adjunct among adult emergency department (ED) patients with rib fractures using mean morphine milligram equivalents as the primary outcome.

• Phase: Phase 1/Phase 2
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Yale University
• Treatments: Bupivacaine

Criteria

Inclusion Criteria:

1. radiographic evidence of unilateral rib fracture(s).

2. able to consent and actively participate in the study.

3. moderate to severe pain (defined as numerical pain rating score >/ 4 ) at time of enrollment.

Exclusion Criteria:

1. known allergy or hypersensitivity to local anesthetics or morphine.

2. infection at site of ESP block placement.

3. depth over 5 cm from skin to transverse process visualized with ultrasound.

4. additional injuries that preclude positioning for ESP block placement.

5. severe traumatic brain or spinal cord injury.

6. severe altered mental status, such that pain could not be assessed.

7. extra thoracic injuries for which rib pain is reported as less than the rest of the injuries.

8. adjunctive epidural catheter pain control.

9. other regional anesthetic blocks.

10. pregnancy or prisoner status.

11. unstable vital signs.