Sossio Serra, Domenico Pietro Santonastaso, Giuseppe Romano, Alessandro Riccardi, Stefano Geniere Nigra, Emanuele Russo, Mario Angelini, Vanni Agnoletti, Mario Guarino, Claudia Sara Cimmino, Michele Domenico Spampinato, Raffella Francesconi, Fabio De Iaco
{"title":"急诊科多发性肋骨骨折患者使用前锯肌平面阻滞(SAP 阻滞)止痛的有效性和安全性:一项回顾性研究。","authors":"Sossio Serra, Domenico Pietro Santonastaso, Giuseppe Romano, Alessandro Riccardi, Stefano Geniere Nigra, Emanuele Russo, Mario Angelini, Vanni Agnoletti, Mario Guarino, Claudia Sara Cimmino, Michele Domenico Spampinato, Raffella Francesconi, Fabio De Iaco","doi":"10.1007/s00068-024-02597-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Chest trauma is a severe and frequent cause of admission to the emergency department (ED). The serratus anterior plane (SAP) block seems to be an effective method of pain management; however, data on efficacy and safety of a single SAP block performed in the ED by emergency physicians (EP) are limited. This study aimed to compare SAP block performed by the EP in the ED plus standard therapy to standard therapy alone in terms of pain severity at 0-3-6-12-18 and 24 h, total opioid consumption (milligrams of morphine equivalents, MME), respiratory function (SpO2/FiO2 ratio), and adverse events (i.e. pneumothorax, infections in the site of injection, or Local Anaesthetic Systemic Toxicity syndrome due to SAP block) in the first 24 h.</p><p><strong>Methods: </strong>This retrospective, monocentric study included adult patients admitted to the Sub-intensive Care Unit (SICU) of the ED with multiple rib fractures between 01/2022 and 03/2023.</p><p><strong>Results: </strong>156 patients (65.4% male; median age 62 years; median injury severity score 16; median thoracic trauma severity score 8) were included. 75 (48.2%) underwent SAP block. Patients undergoing SAP block showed significantly less pain 3-6-18 h after a single block, required less MME (0 [0-20] vs. 20 [0-40], p < 0.001), showed higher SpO2/FiO2 ratio, and no adverse events were reported.</p><p><strong>Conclusion: </strong>The SAP block, in combination with standard therapy, appeared to be more effective in providing pain relief than standard therapy alone in patients admitted to the SICU for traumatic rib fractures.</p>","PeriodicalId":12064,"journal":{"name":"European Journal of Trauma and Emergency Surgery","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Efficacy and safety of the serratus anterior plane block (SAP block) for pain management in patients with multiple rib fractures in the emergency department: a retrospective study.\",\"authors\":\"Sossio Serra, Domenico Pietro Santonastaso, Giuseppe Romano, Alessandro Riccardi, Stefano Geniere Nigra, Emanuele Russo, Mario Angelini, Vanni Agnoletti, Mario Guarino, Claudia Sara Cimmino, Michele Domenico Spampinato, Raffella Francesconi, Fabio De Iaco\",\"doi\":\"10.1007/s00068-024-02597-6\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Chest trauma is a severe and frequent cause of admission to the emergency department (ED). The serratus anterior plane (SAP) block seems to be an effective method of pain management; however, data on efficacy and safety of a single SAP block performed in the ED by emergency physicians (EP) are limited. This study aimed to compare SAP block performed by the EP in the ED plus standard therapy to standard therapy alone in terms of pain severity at 0-3-6-12-18 and 24 h, total opioid consumption (milligrams of morphine equivalents, MME), respiratory function (SpO2/FiO2 ratio), and adverse events (i.e. pneumothorax, infections in the site of injection, or Local Anaesthetic Systemic Toxicity syndrome due to SAP block) in the first 24 h.</p><p><strong>Methods: </strong>This retrospective, monocentric study included adult patients admitted to the Sub-intensive Care Unit (SICU) of the ED with multiple rib fractures between 01/2022 and 03/2023.</p><p><strong>Results: </strong>156 patients (65.4% male; median age 62 years; median injury severity score 16; median thoracic trauma severity score 8) were included. 75 (48.2%) underwent SAP block. Patients undergoing SAP block showed significantly less pain 3-6-18 h after a single block, required less MME (0 [0-20] vs. 20 [0-40], p < 0.001), showed higher SpO2/FiO2 ratio, and no adverse events were reported.</p><p><strong>Conclusion: </strong>The SAP block, in combination with standard therapy, appeared to be more effective in providing pain relief than standard therapy alone in patients admitted to the SICU for traumatic rib fractures.</p>\",\"PeriodicalId\":12064,\"journal\":{\"name\":\"European Journal of Trauma and Emergency Surgery\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2024-07-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Journal of Trauma and Emergency Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00068-024-02597-6\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"EMERGENCY MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Trauma and Emergency Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00068-024-02597-6","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"EMERGENCY MEDICINE","Score":null,"Total":0}
引用次数: 0
摘要
目的:胸部创伤是急诊科(ED)常见的严重入院原因。前锯肌平面(SAP)阻滞似乎是一种有效的止痛方法;然而,由急诊科医生(EP)在急诊室进行单次 SAP 阻滞的有效性和安全性数据却很有限。本研究旨在比较急诊科医生在急诊室实施 SAP 阻滞术加标准疗法与单纯标准疗法在 0-3-6-12-18 小时和 24 小时内的疼痛严重程度、阿片类药物总用量(毫克吗啡当量,MME)、呼吸功能(SpO2/FiO2 比值)和头 24 小时内的不良事件(即气胸、注射部位感染或 SAP 阻滞术导致的局麻药全身中毒综合征):这项回顾性单中心研究纳入了 2022 年 1 月至 2023 年 3 月期间因多发性肋骨骨折入住急诊科重症监护病房(SICU)的成人患者:共纳入 156 名患者(65.4% 为男性;中位年龄 62 岁;中位损伤严重程度评分 16 分;中位胸部创伤严重程度评分 8 分)。75人(48.2%)接受了SAP阻滞治疗。接受SAP阻滞的患者在单次阻滞后3-6-18小时疼痛明显减轻,所需的MME也更少(0 [0-20] vs. 20 [0-40],p 结论:接受SAP阻滞的患者在单次阻滞后3-6-18小时疼痛明显减轻,所需的MME也更少:对于因外伤性肋骨骨折入住SICU的患者,SAP阻滞与标准疗法相结合似乎比单独使用标准疗法更能有效缓解疼痛。
Efficacy and safety of the serratus anterior plane block (SAP block) for pain management in patients with multiple rib fractures in the emergency department: a retrospective study.
Purpose: Chest trauma is a severe and frequent cause of admission to the emergency department (ED). The serratus anterior plane (SAP) block seems to be an effective method of pain management; however, data on efficacy and safety of a single SAP block performed in the ED by emergency physicians (EP) are limited. This study aimed to compare SAP block performed by the EP in the ED plus standard therapy to standard therapy alone in terms of pain severity at 0-3-6-12-18 and 24 h, total opioid consumption (milligrams of morphine equivalents, MME), respiratory function (SpO2/FiO2 ratio), and adverse events (i.e. pneumothorax, infections in the site of injection, or Local Anaesthetic Systemic Toxicity syndrome due to SAP block) in the first 24 h.
Methods: This retrospective, monocentric study included adult patients admitted to the Sub-intensive Care Unit (SICU) of the ED with multiple rib fractures between 01/2022 and 03/2023.
Results: 156 patients (65.4% male; median age 62 years; median injury severity score 16; median thoracic trauma severity score 8) were included. 75 (48.2%) underwent SAP block. Patients undergoing SAP block showed significantly less pain 3-6-18 h after a single block, required less MME (0 [0-20] vs. 20 [0-40], p < 0.001), showed higher SpO2/FiO2 ratio, and no adverse events were reported.
Conclusion: The SAP block, in combination with standard therapy, appeared to be more effective in providing pain relief than standard therapy alone in patients admitted to the SICU for traumatic rib fractures.
期刊介绍:
The European Journal of Trauma and Emergency Surgery aims to open an interdisciplinary forum that allows for the scientific exchange between basic and clinical science related to pathophysiology, diagnostics and treatment of traumatized patients. The journal covers all aspects of clinical management, operative treatment and related research of traumatic injuries.
Clinical and experimental papers on issues relevant for the improvement of trauma care are published. Reviews, original articles, short communications and letters allow the appropriate presentation of major and minor topics.