Continuous Erector Spinae Plane Blocks for Rib Fractures
Status:
Recruiting
Trial end date:
2023-12-01
Target enrollment:
Participant gender:
Summary
Rib fractures are one of the most common injuries in trauma patients. These fractures are
associated with significant pain as well as decreased ability to inspire deeply or cough to
clear secretions, which together lead to complications of the lungs and breathing which leads
to risks of further injury and even death.
One recent study found that the ability to move air into and out of the lungs practically
doubled with the administration of a single-injection Erector Spainae Plane Block (ESPB)
while pain levels nearly halved. However, a single-injection nerve block lasts less than 24
hours while a perineural local anesthetic infusion (also termed a "continuous peripheral
nerve block") may be administered for multiple days. This entails inserting a tiny tube
through the skin and into the area around the nerves, after which more local anesthetic may
be administered prolonging the numbing effects.
The possibility of extending the duration of a ESPB with local anesthetic administration via
a perineural catheter has not be investigated. We therefore are conducting a randomized,
triple-masked, placebo-controlled, parallel-arm study to investigate the addition of a
continuous ESPB to a single-injection ESPB following traumatic rib fractures.
The primary outcome of this study will be the maximum inspired volume measured by incentive
spirometry on the afternoon following the nerve block procedure. We hypothesize that the
maximum inspired volume will be significantly increased in the afternoon following the
procedure with the addition of a continuous ESPB to a single-injection ESPB.