Interpleural block for patients with multiple rib fractures: Comparison with epidural block

Shinohara, Kazuhiko; Iwama, Hiroshi; Akama, Yoichi; Tase, Choichiro

doi:10.1016/0736-4679(94)90337-9

Cited by 24 publications

(19 citation statements)

References 15 publications

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“…One study only enrolled patients who were suffering from flail chest, 41 while three other studies only included patients with unilateral rib fractures. 39,40,43 Two studies only included patients under mechanical ventilation. 41,43 In all studies, patients had a normal level of consciousness.…”

Section: Search Resultsmentioning

confidence: 99%

“…41 Six trials were conducted in North America [36][37][38][39]42,43 and two were conducted in Asia. 40,41 Seven were presented as full publications [37][38][39][40][41][42][43] and one was presented as an abstract. 36 The eight studies only included patients who were older than 18 years of age with multiple rib fractures.…”

Section: Search Resultsmentioning

confidence: 99%

“…34,35 Therefore, eight studies, including a total of 232 patients, met inclusion criteria for this systematic review (Table 1). [36][37][38][39][40][41][42][43] Study characteristics Seven studies were published in English [36][37][38][39][40]42,43 and one in Turkish. 41 Six trials were conducted in North America [36][37][38][39]42,43 and two were conducted in Asia.…”

Section: Search Resultsmentioning

confidence: 99%

“…41,43 In all studies, patients had a normal level of consciousness. [36][37][38][39][40][41][42][43] Exclusion criteria were mentioned in six studies: spinal cord injury or spine fracture, 36,37,42 need for mechanical ventilation, 40 or contraindications to epidural catheter insertion, such as hemodynamic instability and coagulopathy. [36][37][38] Three studies compared the effect of thoracic epidural analgesia (TEA) with local anesthetics to parenteral opioids, 37,38,41 two studies compared TEA with local anesthetics to interpleural analgesia, 39,40 and three studies compared epidural analgesia with opioids to parenteral opioids.…”

Section: Search Resultsmentioning

confidence: 99%

“…[36][37][38][39][40][41][42][43] Exclusion criteria were mentioned in six studies: spinal cord injury or spine fracture, 36,37,42 need for mechanical ventilation, 40 or contraindications to epidural catheter insertion, such as hemodynamic instability and coagulopathy. [36][37][38] Three studies compared the effect of thoracic epidural analgesia (TEA) with local anesthetics to parenteral opioids, 37,38,41 two studies compared TEA with local anesthetics to interpleural analgesia, 39,40 and three studies compared epidural analgesia with opioids to parenteral opioids. 36,42,43 Five studies reported data on at least one of the primary outcomes: mortality (n = 4), [37][38][39][40] ICU LOS (n = 5), [36][37][38]41,43 hospital LOS (n = 5), [36][37][38]42,43 and duration of mechanical ventilation (n = 3) 37,41,43 ( Table 2).…”

Section: Search Resultsmentioning

confidence: 99%

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Effect of epidural analgesia in patients with traumatic rib fractures: a systematic review and meta-analysis of randomized controlled trials

Carrier

Turgeon

Nicole

et al. 2009

Can J Anesth/J Can Anesth

171

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Purpose A consensus group recently proposed epidural analgesia as the optimal analgesic modality for patients with multiple traumatic rib fractures. However, its beneficial effects are not consistently recognized in the literature. We performed a systematic review and a meta-analysis of randomized controlled trials (RCT) of epidural analgesia in adult patients with traumatic rib fractures. Methods A systematic search strategy was applied to MEDLINE, EMBASE, the Cochrane Library and to the annual meeting of relevant societies (up to July 2008). All randomized controlled trials comparing epidural analgesia with other analgesic modalities in adult patients with traumatic rib fractures were included. Primary outcomes were mortality, ICU length of stay (LOS), hospital LOS and duration of mechanical ventilation. Results Eight studies (232 patients) met eligibility criteria. Epidural analgesia did not significantly affect mortality (odds ratio [OR] 1.6, 95% CI, 0.3, 9.3, 3 studies, n = 89), ICU LOS (weighted mean difference [WMD] -3.7 days, 95% CI, -11.4, 4.0, 4 studies, n = 135), hospital LOS (WMD -6.7, 95% CI, -19.8, 6.4, 4 studies, n = 140) or duration of mechanical ventilation (WMD -7.5, 95% CI, -16.3, 1.2, 3 studies, n = 101). Duration of mechanical ventilation was decreased when only studies using thoracic epidural analgesia with local anesthetics were evaluated (WMD -4.2, 95% CI, -5.5, -2.9, 2 studies, n = 73). However, hypotension was significantly associated with the use of thoracic epidural analgesia with local anesthetics (OR 13.76, 95% CI, 2.89, 65.51, 3 studies, n = 99).Abstract presentation: Presented in part at the Residents' Competition at the 62nd Annual Meeting of the Canadian Anesthesiologists' Society,

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Section: Search Resultsmentioning

confidence: 99%