Erector Spinae Plane (ESP) Versus Paravertebral Nerve (PVB) Blockade for Acute Unilateral Rib Fracture Pain
Status:
Terminated
Trial end date:
2019-05-07
Target enrollment:
Participant gender:
Summary
Continuous paravertebral analgesia and erector spinae plane blockade (ESP) are accepted
techniques at University of Pittsburgh Medical Center (UPMC) for the management of thoracic
pain following surgery and trauma. Recently, an increasing number of erector spinae plane
blocks are being performed as it has been demonstrated in our institution and via case
reports that they provide clinical effectiveness, but may have a better side-effect profile
than the paravertebral nerve block. However, the relative efficacy of ESP and continuous
paravertebral analgesia for patients with rib fractures remains to be established. This study
will include 60 consecutive patients presenting to the UPMC Presbyterian Acute Interventional
Perioperative Pain Service suffering from unilateral rib fractures and will be randomized to
receive either nerve blocks via continuous paravertebral infusion or via erector spinae plane
infusion. In addition, to treat breakthrough pain, the patients in both arms will receive
multimodal adjunctive therapy per routine. Bupivicaine and ropivicaine are FDA approved for
use in nerve block catheters. The primary outcome will be total opioid consumption in the
first 3 days of nerve block. Secondary outcomes include highest visual analog pain score
(VAS) with deep breathing and at rest, adverse events, and total number of nerve blocks.
Other data points include time to readiness for discharge, and length of hospital stay.