Erector spinae plane block as analgesic adjunct for traumatic rib fractures in intensive care unit

Beh, Zhi Yuen; Lim, Siu Min; Lim, Woon Lai; Sitaram, Premela Naidu

doi:10.4103/ija.ija_1110_20

Cited by 6 publications

(8 citation statements)

References 8 publications

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“…Of the 37 studies included, 10 were case reports, [18][19][20][21][22][23][24][25][26][27] 12 were case series, [28][29][30][31][32][33][34][35][36][37][38][39] 5 were cohort studies, 7,40-43 2 were randomized controlled trials (RCT), 44,45 1 was a prospective interventional study, 46 and 7 were letters to the editor. [47][48][49][50][51][52][53] The majority of studies were published after 2020, with 29% being published in 2022. A summary of the results of the cohort studies is shown in Table 1.…”

Section: Resultsmentioning

confidence: 99%

Erector Spinae Plane Block as an Analgesic Intervention in Acute Rib Fractures: A Scoping Review

Jiang¹,

Peri²,

Yang³

et al. 2023

LRA

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Rib fractures are a common sequelae of chest trauma and are associated with significant morbidity. The erector spinae nerve block (ESB) has been proposed as an alternative first-line regional technique for rib fractures due to ease of administration and minimal complication profile. We aimed to investigate the current literature surrounding this topic with a focus on pain and respiratory outcomes. Methods: A comprehensive literature search was performed on the Medline, Embase, Web of Science, Scopus, and Cochrane databases. Keywords of "erector spinae block" and "rib fractures" were used to form the search strategy. Papers published in English investigating ESB as an analgesic intervention for acute rib fracture were included. Exclusion criteria were operative rib fixation, or where the indication for ESB was not rib fracture. Results: There were 37 studies which met the inclusion criteria for this scoping review. Of these, 31 studies reported on pain outcomes and demonstrated a 40% decrease in pain scores post administration within the first 24 hours. Respiratory parameters were reported in 8 studies where an increase in incentive spirometry was demonstrated. Respiratory complication was not consistently reported. ESB was associated with minimal complications; only 5 cases of haematoma and infection were (incidence 0.6%) reported, none of which required further intervention. Discussion: Current literature surrounding ESB in rib fracture management provides a positive qualitative evaluation of efficacy and safety. Improvements in pain and respiratory parameters were almost universal. The notable outcome from this review was the improved safety profile of ESB. The ESB was not associated with complications requiring intervention even in the setting of anticoagulation and coagulopathy. There still remains a paucity of large cohort, prospective data. Moreover, no current studies reflect an improvement in respiratory complication rates compared to current techniques. Taken together, these areas should be the focus of any future research.

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Section: Resultsmentioning

confidence: 99%

Erector Spinae Plane Block as an Analgesic Intervention in Acute Rib Fractures: A Scoping Review

Jiang¹,

Peri²,

Yang³

et al. 2023

LRA

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“…Nonsteroidal anti-inflammatory drugs, acetaminophen, gabapentinoids, opioids and regional methods can be used in the analgesia management of critically ill patients in ICU [7,10,14,15]. NSAIDs have disadvantages such as gastric damage, platelet inhibition, and kidney injury.…”

Section: Case Reportmentioning

confidence: 99%

“…This technique is widely used in neuropathic pain such as rib metastasis and postoperative and posttraumatic pain [9,15,18,19,20]. Recently, usage of ESP block has become widespread for the treatment of pain due to multiple rib fractures [10,13]. This technique can be used safely in ICU patients because of easy sonoanatomy, less invasiveness compared to neuraxial methods, being away from major vascular structures and fewer complications [2,9,10,21].…”

Section: Case Reportmentioning

confidence: 99%

“…Recently, usage of ESP block has become widespread for the treatment of pain due to multiple rib fractures [10,13]. This technique can be used safely in ICU patients because of easy sonoanatomy, less invasiveness compared to neuraxial methods, being away from major vascular structures and fewer complications [2,9,10,21]. ESP block can be easily performed with USG at the bedside among critically ill patients.…”

Section: Case Reportmentioning

confidence: 99%

“…Usage of ESP block has become widespread in the treatment of pain due to multiple rib fractures [2,9]. This technique can be used safely among ICU patients because of easy sonoanatomy, less invasiveness compared to neuraxial methods, and being away from major vascular structures [10,11].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Pain Management of A Critically Ill Oldest-Old Trauma Patient with Multiple Rib Fractures in Intensive Care Unit

Yazar,

Yesiler,

Sahinturk

et al. 2024

Preprint

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Rib fractures due to blunt chest trauma is a painful condition with high morbidity and mortality that is twice as high in the elderly compared to young people. If adequate analgesia treatment is not provided, respiratory complications, the need for mechanical ventilation and the length of stay in intensive care unit (ICU) may increase. Erector spinal plane (ESP) block is a regional anesthesia method that can provide effective analgesia in unilateral thoracic region. Here, ESP block, which is used successfully in pain management of a critically ill oldest-old patient with multiple rib fractures in ICU, is presented

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Comparison of Ultrasound-Guided Erector Spinae Plane Block With Intercostal Nerve Block for Trauma-Associated Chest Wall Pain

Armin

Movahedi

Najafzadeh

et al. 2022

The Journal of Emergency Medicine

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Erector spinae plane block as analgesic adjunct for traumatic rib fractures in intensive care unit

Cited by 6 publications

References 8 publications

Erector Spinae Plane Block as an Analgesic Intervention in Acute Rib Fractures: A Scoping Review

Erector Spinae Plane Block as an Analgesic Intervention in Acute Rib Fractures: A Scoping Review

Pain Management of A Critically Ill Oldest-Old Trauma Patient with Multiple Rib Fractures in Intensive Care Unit

Comparison of Ultrasound-Guided Erector Spinae Plane Block With Intercostal Nerve Block for Trauma-Associated Chest Wall Pain

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