Intercostal nerve block proved superior to systemic analgesia in the control of chest pain in patients with traumatic rib fractures
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 3
Abstract
Objective: This study was carried out to compare the efficacy of intravenous tramadol injection and intercostal nerve block with 0.5% bupivacaine injection for control of chest pain in multiple rib fractures. Methods: Prospective randomized study of intercostal nerve block (ICNB) with 0.5% bupivacaine group (n=30) and the intravenous tramadol (IVT) injection group (n=34). Results: There were 64 adult patients who were studied with multiple rib fractures caused by blunt chest trauma. Before analgesia, 33.3% and 66.7% of patients in the ICNB group rated their pain as moderate and severe respectively while 29.4% and 70.6% of patients in the IVT group rated their pain as moderate and severe respectively (p= 0.917). However at one hour post commencement of analgesic, 13.3%, 70%, 16,7%, and 0% rated their chest pain as no pain, mild pain, moderate pain and severe pain respectively among the ICNB group while in the IVT group the respective figures were 0%, 23.5%, 64.7% and 11.8% (p value <0,0001); and at 24hours post commencement of analgesic the equivalent figures were 0%, 90%, 10% and 0% in ICNB group against 0%, 76.6%, 23.4% and 0% in the IVT group (p=0.002). Comparison of efficacy based on improvement in pain scores among the two groups of intervention showed that ICNB was superior to IVT at both the one hour and 24 hours re-assessment periods. Conclusion: This study shows that ICNB is superior to IVT in chest pain control in multiple rib fractures of blunt chest trauma.
Authors and Affiliations
EE Ekpe, OO Bassey, AU Etiuma, MC Ikpe
Keywords
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- EP ID EP369650
- DOI 10.9790/0853-1703106874.
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