Erector Spinae Plane Blocks For Traumatic Rib Fractures: A Prospective, Interventional Study - Benja

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 Restricted access Research article First published online May 5, 2022

Erector Spinae Plane Blocks for Traumatic Rib Fractures: A Prospective, Interventional Study

Benjamin J. Palachick, MD , Ryan A. Carver, MD, […], and Jay N. Collins, MD +2 View all authors and a#liations

Volume 88, Issue 9 https://doi.org/10.1177/00031348221091956

 Contents 

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Abstract
Background
Rib fractures are present in 10% of all trauma patients and 30% of patients with signi!cant chest trauma.
Pain from rib fractures results in decreased respiratory e"ort which can lead to atelectasis and potentially
pneumonia and death. Pain control is therefore of utmost importance in preventing the complications of rib
fractures by improving respiratory function. Erector spinae plane blocks (ESPB) have been e"ectively used in
elective surgery with subjective and objective improvements in pain.

Materials and Methods


We sought to evaluate subjective pain and objective evaluation of respiratory e"ort by way of incentive
Related content

spirometry levels after administration of an ESPB for patients with rib fractures. Our trauma service applied
ESPB over 2 years in patients with rib fractures. Ultrasound guidance was used to administer 50cc of a long- Similar articles:
acting local anesthetic at the transverse process underneath the erector spinae muscle group. Evaluation of
pain scores and incentive spirometry levels were measured prior to and after the ESPB. Restricted access

Utilization of Percentage of
Results Predicted Forced Vital Capacity to
Stratify Rib Fracture Patients: An
In total, we obtained data from 45 patients. Mean pre-pain scores were 7.93 with post-pain scores of 4.47 (p Updated Clinical Practice Guideline
< 0.001). Mean pre-block incentive spirometry volumes were 1160 cc with post-block IS of 1495cc (p 0.035). Show details 
There were no associated complications.

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Discussion
Video-Assisted Thoracoscopic
ESPBs are safe and signi!cantly reduce pain scores and increased incentive spirometry volumes after Internal Rib Fixation
administration. They are easy to perform and can be done by the trauma service, including trainees. ESPB Show details 
has the potential to reduce pulmonary complications of rib fractures, as well as subjectively improving pain
experienced by our trauma patients. Based on our results, we recommend this block as an adjunct to Restricted access
multimodal analgesia for patients with rib fractures. Bedside Incentive Spirometry
Predicts Risk of Pulmonary
Complication in Patients with Rib
Fractures
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References SAGE Knowledge


Entry
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