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IRCT20190314043050N1 IRCT 2019-05-27 Kermanshah University of Medical Sciences Serratus anterior plane block technique in multiple traumatic rib fractures Comparison of the effect of Serratus anterior plain block technique with intercostal nerve block technique in reducing pain following multiple rib fractures in emergency department 2019-04-25 anticipated 40 Complete https://irct.ir/trial/38347 interventional Randomization: Randomized, Blinding: Single blinded, Placebo: Not used, Assignment: Other, Purpose: Treatment, Randomization description: Patients are randomly divided into control and test groups by the complete randomization method, Blinding description: after completing interventions, patients' evaluation checklist will be decoded. Assessment and registration is carried out by a specific person for each patient. These evaluators are blind to the type of the procedure performed in the recovery room. In fact, Patient information is recorded before and after the process by the assistant who is unaware of the him/her study grouping. N/A Multiple traumatic rib fractures. Intervention 1: Intervention group: serratus anterior plane block technique under ultrasound guidance. This method is similar to the pectoralis nerve and trans-abdominal plate blocks and, due to the special anatomy of the Sarratus muscle, it traverses a wide area of ​​the chest wall. Patients in the intervention group will be in a supine position with the hands placed above the head. After providing sterile conditions, local anesthetic technique begins. An ultrasound linear probe of 3 to 16 MHz is placed in the middle axillary line at the fifth rib. A Touhy's 18G needle is placed between the anterior serratus and the external intercostal muscles. After negative aspiration and confirmation of needle location by initial hydro-dissection with 2 to 3 ml of solution, 20 ml of Ropivacaine hydrochloride will be injected 5 mg / ml in the cephalad_caudal direction on the plate. Intervention 2: Control group: intercostal nerve block. This procedure is done between the posterior and middle axillary lines. A 10-ml syringe with a needle of 3.375 and 25 guage is used. The skin of the affected area will be prepared by the usual aseptic method. To perform this technique, the second finger of the non-dominant hand draws the lower edge of the rib upwards. The needle at an angle of 80 degrees to the chest wall, enters the skin to slowly hit the lower edge of the rib. At this time, the finger is removed and the needle is pulled in the intercostal space. We dip the needle 3 millimeter and aspirate. Then, 2 to 4 ml of ropivacaine hydrochloride will be given at a dose of 5 mg / ml to a maximum dose of 2.5 mg per kg body weight. The procedure is repeated in two gears up and down the premises. Yes - There is a plan to make this available What will be shared: The whole potential data can be shared after identifying individuals and their information When: Since 1399 To whom: Researchers working in academic institutions Conditions: - Where to obtain: Ah_meysami@kums.ac.ir How to obtain: After contacting the designer email Ah_meysami@kums.ac.ir Comments:
public Amirhossein Meysami
Parastar Blvd, Imam Reza hospital
Kermanshah Iran (Islamic Republic of) 6715847141 +98 83 3427 6301 ah_meysami@kums.ac.ir Kermanshah University of Medical Sciences scientific Amirhossein Meysami
Parastar Blvd, Imam Reza hospital
Kermanshah Iran (Islamic Republic of) 6715847141 +98 83 3427 6301 ah_meysami@kums.ac.ir Kermanshah University of Medical Sciences Iran (Islamic Republic of) Iran (Islamic Republic of) Patients referred to Imam Reza and Ayatollah Taleghani hospital in Kermanshah, with a complaint of blunt thoracic trauma during 2019 Visual analogue scale of four and more Initial systolic blood pressure of 90 mmHg and more Three-rib fractures and more The patient should be monitored at least twelve hours after interventions 18 years no limit Both Opium addicted patients Pathologic and/or Nontraumatic rib fractures Bilateral rib fractures history of allergy to local anesthetics Pregnancy and/or breastfeeding People with mental and psychological problems who are not able to answer questions Tension pneumothorax occurs Need to intubation and mechanical ventilation Patient dissatisfaction S22 Fracture of rib(s), sternum and thoracic spine Treatment - Other Treatment - Other Intervention group: serratus anterior plane block technique under ultrasound guidance. This method is similar to the pectoralis nerve and trans-abdominal plate blocks and, due to the special anatomy of the Sarratus muscle, it traverses a wide area of ​​the chest wall. Patients in the intervention group will be in a supine position with the hands placed above the head. After providing sterile conditions, local anesthetic technique begins. An ultrasound linear probe of 3 to 16 MHz is placed in the middle axillary line at the fifth rib. A Touhy's 18G needle is placed between the anterior serratus and the external intercostal muscles. After negative aspiration and confirmation of needle location by initial hydro-dissection with 2 to 3 ml of solution, 20 ml of Ropivacaine hydrochloride will be injected 5 mg / ml in the cephalad_caudal direction on the plate. Control group: intercostal nerve block. This procedure is done between the posterior and middle axillary lines. A 10-ml syringe with a needle of 3.375 and 25 guage is used. The skin of the affected area will be prepared by the usual aseptic method. To perform this technique, the second finger of the non-dominant hand draws the lower edge of the rib upwards. The needle at an angle of 80 degrees to the chest wall, enters the skin to slowly hit the lower edge of the rib. At this time, the finger is removed and the needle is pulled in the intercostal space. We dip the needle 3 millimeter and aspirate. Then, 2 to 4 ml of ropivacaine hydrochloride will be given at a dose of 5 mg / ml to a maximum dose of 2.5 mg per kg body weight. The procedure is repeated in two gears up and down the premises. Score changes in visual analogue scale system. Timepoint: Immediately after the intervention, the first 30 minutes, one, six, and 12 hours after. Method of measurement: Visual analogue scale and modified Qor-40 score checklist. Dosage of Fentanyl used. Timepoint: thirty minutes to twelve hours after intervention. Method of measurement: Microgram per Kg. Kermanshah University of Medical Sciences Approved 2019-04-24 Ethics committee of Kermanshah university of medical sciences Parastar blvd, Imam Reza hospital Kermanshah Kermanshah Iran (Islamic Republic of)