Impact of serratus plane block on pain scores and incentive spirometry volumes after chest trauma

IF 1.5 Q3 ANESTHESIOLOGY Local and Regional Anesthesia Pub Date : 2019-08-01 DOI:10.2147/LRA.S207791
Nadia Hernandez, J. D. de Haan, Dallis Clendenin, D. Meyer, Semhar J. Ghebremichael, C. Artime, George Williams, H. Eltzschig, S. Sen
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引用次数: 15

Abstract

Background: Adequate pain control is difficult to achieve in patients with multiple rib fractures (MRF). Serratus plane block (SPB) is a novel technique for alleviating rib fracture pain. Several published case reports support this hypothesis. Purpose: The purpose of this study was to evaluate the use of SPB in MRF at our level 1 trauma center. Methods: Our hospital’s Regional Anesthesia Registry was queried for all trauma patients with MRF who underwent SPB between August 2014 and January 2018. Data were compared in each patient as a matched pair for the time periods before and after undergoing SPB. Thirty-four patients with similar baseline characteristics were enrolled. Results: The median number of rib fractures was 7. Ordinal pain scores were found to be improved 4 hrs after SPB from median 7/10 to 3/10 (P<0.001). Incentive spirometry (IS) volumes recorded 4 and 24 hrs postserratus plane block showed a median increase of 150 and 175 mL from baseline, respectively (P<0.001). IS volumes recorded at 48 hrs showed a median increase of 300 mL from baseline (P<0.001). Respiratory rate decreased from a median value of 24.5 to 16 breaths/min (P<0.001). SpO2 was improved at 24 hrs from median 96% to 99% (P<0.001). Conclusion: SPB improves pain scores and IS volumes in MRF. Because it is not limited by patient positioning or anticoagulation and has a better safety profile, it may offer a viable alternative to neuraxial techniques. Additional studies are necessary to evaluate its efficacy compared to neuraxial techniques.
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胸外伤后锯肌平面阻滞对疼痛评分和刺激肺活量的影响
背景:多发性肋骨骨折(MRF)患者很难实现充分的疼痛控制。Serratus平面阻滞(SPB)是一种新型的缓解肋骨骨折疼痛的技术。一些已发表的案例报告支持这一假设。目的:本研究旨在评估SPB在我们一级创伤中心MRF中的应用。方法:查询2014年8月至2018年1月期间接受SPB的所有MRF创伤患者的医院区域麻醉登记处。将每位患者在接受SPB前后的时间段内的数据作为匹配对进行比较。34名具有相似基线特征的患者被纳入研究。结果:肋骨骨折的中位数为7。SPB后4小时,常规疼痛评分从中位数7/10提高到3/10(P<0.001)。刺激性肺活量测定术(IS)记录的4小时和24小时后平面阻滞的容积显示,中位数比基线增加了150和175 mL,分别为(P<0.001)。48小时记录的IS体积比基线增加了300mL(P<0.01)。呼吸频率从24.5的中值降至16次呼吸/分钟(P<001)。SpO2在24小时从中值96%提高到99%(P<.001)。结论:SPB改善了MRF中的疼痛评分和IS体积。因为它不受患者定位或抗凝治疗的限制,并且具有更好的安全性,它可能为神经轴技术提供一种可行的替代方案。与神经轴技术相比,有必要进行更多的研究来评估其疗效。
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来源期刊
CiteScore
6.30
自引率
0.00%
发文量
12
审稿时长
16 weeks
期刊最新文献
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