The effect of erector spinae plane block on respiratory and analgesic outcomes in multiple rib fractures: a retrospective cohort study

Sanjib Adhikary, W. M. Liu, E. Fuller, Hillenn Cruz Eng, K. J. Chin

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Regional anaesthesia is often helpful in improving respiratory function and analgesia following multiple rib fractures. The erector spinae plane block has become the technique of choice in our institution due to its relative simplicity and purported safety. The aim of this retrospective cohort study was to determine its effectiveness in improving respiratory and analgesic outcomes. We reviewed electronic medical records of patients with traumatic rib fractures admitted to a level-one trauma centre between January 2016 and July 2017, who also received erector spinae plane blocks. We analysed the following outcomes before and up to 72 h after erector spinae plane blockade: incentive spirometry volume; maximum numerical rating scale static pain scores; and 12-h opioid consumption. Pre- and post-block data were compared. We included 79 patients, 77% of whom received continuous erector spinae plane block for a mean (SD) of 3.7 (1.9) days. The majority (85%) had other associated injuries. Incentive spirometry volumes improved from 784 (694) to 1375 (667) ml (p < 0.01) during the first 24 h following erector spinae plane blockade. Pain scores were reduced from 7.7 (2.5) to 4.7 (3.2) in the first three hours (p < 0.01). Reductions in opioid consumption were observed but did not achieve statistical significance. These improvements were largely sustained for up to 72 h. Mean arterial blood pressure remained unchanged from baseline. In conclusion, erector spinae plane blocks were associated with improved inspiratory capacity and analgesic outcomes following rib fracture, without haemodynamic instability. We propose that it should be considered to be a viable alternative to other regional analgesic techniques when these are not feasible.

Original languageEnglish (US)
Pages (from-to)585-593
Number of pages9
JournalAnaesthesia
Volume74
Issue number5
DOIs
StatePublished - May 1 2019

Fingerprint

Rib Fractures
Analgesics
Cohort Studies
Retrospective Studies
Spirometry
Opioid Analgesics
Motivation
Arterial Pressure
Inspiratory Capacity
Pain
Conduction Anesthesia
Electronic Health Records
Trauma Centers
Analgesia
Hemodynamics
Safety
Wounds and Injuries
Multiple Fractures

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine

Cite this

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title = "The effect of erector spinae plane block on respiratory and analgesic outcomes in multiple rib fractures: a retrospective cohort study",
abstract = "Regional anaesthesia is often helpful in improving respiratory function and analgesia following multiple rib fractures. The erector spinae plane block has become the technique of choice in our institution due to its relative simplicity and purported safety. The aim of this retrospective cohort study was to determine its effectiveness in improving respiratory and analgesic outcomes. We reviewed electronic medical records of patients with traumatic rib fractures admitted to a level-one trauma centre between January 2016 and July 2017, who also received erector spinae plane blocks. We analysed the following outcomes before and up to 72 h after erector spinae plane blockade: incentive spirometry volume; maximum numerical rating scale static pain scores; and 12-h opioid consumption. Pre- and post-block data were compared. We included 79 patients, 77{\%} of whom received continuous erector spinae plane block for a mean (SD) of 3.7 (1.9) days. The majority (85{\%}) had other associated injuries. Incentive spirometry volumes improved from 784 (694) to 1375 (667) ml (p < 0.01) during the first 24 h following erector spinae plane blockade. Pain scores were reduced from 7.7 (2.5) to 4.7 (3.2) in the first three hours (p < 0.01). Reductions in opioid consumption were observed but did not achieve statistical significance. These improvements were largely sustained for up to 72 h. Mean arterial blood pressure remained unchanged from baseline. In conclusion, erector spinae plane blocks were associated with improved inspiratory capacity and analgesic outcomes following rib fracture, without haemodynamic instability. We propose that it should be considered to be a viable alternative to other regional analgesic techniques when these are not feasible.",
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The effect of erector spinae plane block on respiratory and analgesic outcomes in multiple rib fractures : a retrospective cohort study. / Adhikary, Sanjib; Liu, W. M.; Fuller, E.; Cruz Eng, Hillenn; Chin, K. J.

In: Anaesthesia, Vol. 74, No. 5, 01.05.2019, p. 585-593.

Research output: Contribution to journalArticle

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