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

IF 1.5 Q3 ANESTHESIOLOGY
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.
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。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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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
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