PVB vs Ketamine/Lidocaine in Rib Fracture Patients
Status:
Recruiting
Trial end date:
2022-05-01
Target enrollment:
Participant gender:
Summary
Rib fractures are a common admission to the trauma service. The mainstay of treatment is pain
control to improve respiratory effort in order to offset the risk of pneumonia and mechanical
ventilation. In addition to standard pain control modalities, the investigator's institution
utilizes paravertebral blocks as well as lidocaine and ketamine infusions for pain control.
The current standard of care for pain control is to begin with acetaminophen, ibuprofen or
celecoxib and opioids with the addition of paravertebral blocks as needed. In certain
situations, a paravertebral block is contraindicated, and pain control is relegated to
lidocaine and ketamine infusion. The use of lidocaine infusion alone and ketamine infusion
alone for pain control has been studied and has been shown to be safe. However, concurrent
use of these two medications to control rib fracture pain is relatively new and the efficacy
compared to paravertebral block is not known. The goal of the study is to show
non-inferiority of simultaneous lidocaine and ketamine infusions versus paravertebral blocks.