Continuous erector spinae plane block for analgesia and better pulmonary functions in patients with multiple rib fractures: a prospective descriptive study
Bloqueio contínuo do plano eretor da espinha para analgesia e melhor função pulmonar em pacientes com fraturas múltiplas de costelas: estudo descritivo prospectivo
Rashmi Syal, Sadik Mohammed, Rakesh Kumar, Nidhi Jain, Pradeep Bhatia
Abstract
Background
The present study explored the role of continuous erector spinae plane (ESP) block for analgesia as well as its impact on pulmonary functions in patients with multiple rib fractures.
Methods
Ten patients with multiple rib fractures were enrolled after getting informed and written consent. Ultrasound-guided ESP block was performed at the level midway between the fractured ribs followed by the insertion of the catheter. Pre and post-block VAS score, hemodynamics, respiratory rate (RR), peripheral oxygen saturation (SpO2), inspiratory capacity (IC), blood gases (PaO2 and PCO2), and complications were compared.
Results
Pain scores at rest as well as on movement showed a significant reduction from 5.9 and 7.5 pre block to 1.6 and 2.5 respectively at 96 hours (p < 0.0001). Similarly, RR, SpO2, IC, and PaO2 were significantly better after the block placement (p < 0.001).
Conclusion
Continuous ESP block provide adequate analgesia with better respiratory functions in patients with multiple rib fractures.
Keywords
Resumo
Introdução
O presente estudo explorou o papel do bloqueio contínuo do plano eretor da espinha (PEE) para analgesia, bem como seu impacto nas funções pulmonares em pacientes com múltiplas fraturas de costelas.
Métodos
Dez pacientes com fraturas múltiplas de costelas foram incluídos após obtenção de consentimento informado e por escrito. O bloqueio PEE guiado por ultrassom foi realizado no nível médio entre as costelas fraturadas, seguido pela inserção do cateter. Foram comparados escore EVA pré e pós-bloqueio, hemodinâmica, frequência respiratória (FR), saturação periférica de oxigênio (SpO2), capacidade inspiratória (CI), gasometria arterial (PaO2 e PCO2) e complicações.
Resultados
Os escores de dor em repouso e em movimento mostraram uma redução significativa de 5,9 e 7,5 antes do bloqueio para 1,6 e 2,5, respectivamente, às 96 horas (p < 0,0001). Da mesma forma, FR, SpO2, CI e PaO2 foram significativamente melhores após a colocação do bloqueio (p < 0,001).
Conclusão
O bloqueio PEE contínuo proporciona analgesia adequada com melhores funções respiratórias em pacientes com múltiplas fraturas de costelas.
Palavras-chave
References
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Submitted date:
01/08/2021
Accepted date:
09/05/2021
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