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Analgesic efficacy of the serratus anterior plane block in rib fractures pain: A randomized controlled trial
Institution:1. Greater Sydney Area Helicopter Emergency Medical Service, Ambulance Service New South Wales, Sydney, New South Wales, Australia;2. Faculty of Medicine and Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia;3. Discipline of Emergency Medicine, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
Abstract:BackgroundSerratus anterior plane block (SAPB) was evaluated that in patients with the complaint of rib fracture pain in terms of total analgesic consumption and pain scores.MethodSixty patients with rib fracture and NRS (Numeric Rating Scala) pain scores equal or greater than four were included in randomized controlled study. Patients were randomized to perform SAPB or control group. Primary outcome was total tramadol consumption in 24 h. Secondary outcomes were NRS scores (after Patient Controlled Analgesia (PCA) application 30 min, first, second, 4 th, 6 th, 12 th, 24 th hour), peripheral oxygen saturation (first and 24 th hour after PCA application), chronic pain. and complications.ResultsThe total tramadol consumption significantly lower in group S (p = 0.02). NRS scores after 30 min, 1 h, 2 h, 4 h, 6 h, 12 h, and 24 h were significantly lower in group S than in group C (p < 0.001, p < 0.001, p < 0.001, p < 0.001, p = 0.002, p = 0.026). The total number of patients who reported of chronic pain at rest and during effort was significantly lower in group SAPB than in group C (p = 0.006). Nine patients in group C were reported of pain, four of whom had pain at rest and five had pain during effort. One patient in group S was reported of pain during effort.ConclusionThis study demonstrated that SAPB, as part of multimodal analgesia in pain management due to rib fractures, is safe and effective in reducing acute pain.
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