RT Journal Article
SR Electronic
T1 Intercostal nerve blockage for pain control in blunt thoracic trauma
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP p2405
VO 38
IS Suppl 55
A1 H. Volkan Kara
A1 Nuri Tutar
A1 Selma Yesilkaya
A1 Gokhan Ertas
A1 M. Erdem Memetoglu
A1 Kadir Agladioglu
A1 A. Seckin Cetinkaya
YR 2011
UL http://erj.ersjournals.com/content/38/Suppl_55/p2405.abstract
AB Blunt thoracic traumas are common clinical occasions in the emergency rooms. There are several approaches in the medical management of these patients. In this study we evaluated the the safety and efficacy of application of long acting local anesthetic bupivacaine 5% in to the intercostal space.There were 32 consequative patients in a single city state hospital in Turkey. Median age of the patients was 42,4 (22 min 78 max). There were 27 male and 5 female patients. Admission to the ER were due to blunt trauma caused by falling down or motor vehicle accident. The patients who needed to have chest tube insertion either due to pneumothorax or hemothorax were excluded from the study.The Visual Analog Pain Scale was asked every patient before starting treatment. Mean value was 7.8 were patients with fractured ribs (n=12) and 7.3 for the patients without fracture in the ribs (n=20). After the intercostal blokage and the analgesic treatment themean values decreased to 4.2 and 4 respectively in the following 24 hour. The patients discharged from the hospital in the following 3.4 days. The injection of bupivacaine 5% was to 1ml to 3 levels. First was to the site having the most severe pain to the palpation plus one level up and down with the well known standardized method. The procedure was repeated every day during the hospitalization period.Application of 5% bupivacaine into the intercostal space to patients having pain is safe and effective. It decreases the the Visual Analog Pain Scale rapidly, need for non opiod analgesics and decreases the hospitalization period and possible morbidities due to secretion retention. It evidently improve the patients comfort.