Erector Spinae Plane Block for Acute Pain Management in the Emergency Department

NCT03590782 | Completed DMC

• 1 other identifier: Pending
• Study Type: observational
• Target: 10
• Locations: 1 country
• Sites: 1

Brief Summary

Rib fractures are a common cause of respiratory distress in trauma patients as poor pain control and subsequent hypoventilation commonly results in lung tissue collapse (atelectasis). The current mainstay of treatment in rib fractures are oral and intravenous opioids however these are often ineffective and can also precipitate hypoventilation. Recently there has been interest in regional anaesthesia techniques for managing painful conditions of the thorax as a way to avoid pain and opioid related hypoventilation. These techniques include ultrasound guided nerve blocks such as the intercostal, paravertebral and serratus anterior blocks. The use of these techniques is however limited by minimal dermatomal coverage as well as a high incidence of complications The erector spinae plane block is a new, very promising technique which offers a safe means of providing anaesthesia to a large part of the hemithorax with a single injection. The proposed study will seek to establish whether the erector spinae plane block can be successfully used in the emergency department for pain control in patients with acute rib fractures.

Conditions

Rib Fractures; Nerve Block

Outcome Measures

Primary Outcomes (1)

• Visual analogue pain scale

  Pain scale with be taken pre- and post-block and regular intervals. The visual analogue pain scale ranges from 0-10, with 0 being no pain and 10 being the worse pain imaginable. Lower numerical scores are better for outcomes as it implies that the pain is more well managed.

  30-60 minutes

Interventions

Erector Spinae Block OTHER

An ultrasound guided erector spinae block will be performed.

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patients with acute rib fractures failing traditional therapy.

You may qualify if:

• Patients over the age of 18
• Acute rib fractures with pain that is subjectively poorly controlled despite oral and/or intravenous opioids.

You may not qualify if:

• Hemodynamic instability,
• Active infection overlying the site of injection
• Patients receiving anticoagulation
• Patients with a history of a bleeding disorder
• Patients with thrombocytopenia
• Pregnant, are incarcerated
• Decline the procedure
• Inability to provide consent

Sponsors & Collaborators

• University of Manitoba: lead
• Dr. Ian Surdhar: collaborator

Study Sites (1)

Health Sciences Centre

Winnipeg, Manitoba, R3A1R9, Canada

Location

MeSH Terms

Conditions

Rib Fractures

Condition Hierarchy (Ancestors)

Fractures, Bone; Wounds and Injuries; Thoracic Injuries

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 4, 2018
• First Posted: July 18, 2018
• Study Start: March 1, 2019
• Primary Completion: September 30, 2020
• Study Completion: September 30, 2020
• Last Updated: October 12, 2020

Record last verified: 2020-10

Locations

CA (1)