Erector Spinae Plane Fascial Block in Multiple Rib Fractures (Case Report)
The aim of the study: to improve the efficacy of erector spinae plane (ESP) fascial block for pain management in patients with multiple rib fractures. Materials and methods. We observed 4 patients with multiple rib fractures who were treated with ESP fascial block with subsequent prolonged administr...
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Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia
2020-11-01
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| Series: | Общая реаниматология |
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| Online Access: | https://www.reanimatology.com/rmt/article/view/1964 |
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| author | V. Kh. Sharipova I. V. Fokin F. K. Sattarova F. O. Parpibayev |
| author_facet | V. Kh. Sharipova I. V. Fokin F. K. Sattarova F. O. Parpibayev |
| author_sort | V. Kh. Sharipova |
| collection | DOAJ |
| description | The aim of the study: to improve the efficacy of erector spinae plane (ESP) fascial block for pain management in patients with multiple rib fractures. Materials and methods. We observed 4 patients with multiple rib fractures who were treated with ESP fascial block with subsequent prolonged administration of local anesthetic for pain relief. To evaluate the efficacy of the ESP block, the visual analogue scale (VAS) for pain intensity, cough performance index and forced vital capacity (FVC), as well as a modified 3-item scale were used. The distribution of local anesthetic (10% lidocaine solution) and contrast (iohexol solution, 350 mg iodine/ml) media was analyzed by computed tomography and correlated with the data on reduced pain perception according to the thoracic vertebrae (Th) levels.Results. After the ESP block in patients with multiple rib fractures, we found a decrease in VAS pain intensity at rest by 3-4 points and on coughing by 3-6 points, an increase in cough performance by 1 point and in the modified 3-item scale by 1-3 points. The distribution of the local anesthetic solution was registered mainly in the cranial-caudal and anterior direction to the intertransversal space without significant leakage in lateral and medial directions. In all 4 cases the local anesthetic and contrast media spread from the catheter tip cranially several levels of thoracic vertebrae farther than in caudal direction.Conclusion. ESP block in patients with multiple rib fractures is a reasonably effective method of pain relief. Catheterization of the fascial plane of erector spinae muscle should be performed at the level of vertebra corresponding to the underlying fractured rib. The data obtained may serve as a basis for further studies with more patients included. |
| format | Article |
| id | doaj-art-3198b85c3cd84815adef140bcb0297eb |
| institution | DOAJ |
| issn | 1813-9779 2411-7110 |
| language | English |
| publishDate | 2020-11-01 |
| publisher | Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia |
| record_format | Article |
| series | Общая реаниматология |
| spelling | doaj-art-3198b85c3cd84815adef140bcb0297eb2025-08-20T03:18:32ZengFederal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, RussiaОбщая реаниматология1813-97792411-71102020-11-01165222910.15360/1813-9779-2020-5-22-291761Erector Spinae Plane Fascial Block in Multiple Rib Fractures (Case Report)V. Kh. Sharipova0I. V. Fokin1F. K. Sattarova2F. O. Parpibayev3Republican Research Centre for Emergency MedicineRepublican Research Centre for Emergency MedicineTashkent Institute for Continuous Postgraduate Medical EducationIbn Sina HospitalThe aim of the study: to improve the efficacy of erector spinae plane (ESP) fascial block for pain management in patients with multiple rib fractures. Materials and methods. We observed 4 patients with multiple rib fractures who were treated with ESP fascial block with subsequent prolonged administration of local anesthetic for pain relief. To evaluate the efficacy of the ESP block, the visual analogue scale (VAS) for pain intensity, cough performance index and forced vital capacity (FVC), as well as a modified 3-item scale were used. The distribution of local anesthetic (10% lidocaine solution) and contrast (iohexol solution, 350 mg iodine/ml) media was analyzed by computed tomography and correlated with the data on reduced pain perception according to the thoracic vertebrae (Th) levels.Results. After the ESP block in patients with multiple rib fractures, we found a decrease in VAS pain intensity at rest by 3-4 points and on coughing by 3-6 points, an increase in cough performance by 1 point and in the modified 3-item scale by 1-3 points. The distribution of the local anesthetic solution was registered mainly in the cranial-caudal and anterior direction to the intertransversal space without significant leakage in lateral and medial directions. In all 4 cases the local anesthetic and contrast media spread from the catheter tip cranially several levels of thoracic vertebrae farther than in caudal direction.Conclusion. ESP block in patients with multiple rib fractures is a reasonably effective method of pain relief. Catheterization of the fascial plane of erector spinae muscle should be performed at the level of vertebra corresponding to the underlying fractured rib. The data obtained may serve as a basis for further studies with more patients included.https://www.reanimatology.com/rmt/article/view/1964fascial blockerector spinae muscleanalgesiamultiple rib fractures |
| spellingShingle | V. Kh. Sharipova I. V. Fokin F. K. Sattarova F. O. Parpibayev Erector Spinae Plane Fascial Block in Multiple Rib Fractures (Case Report) Общая реаниматология fascial block erector spinae muscle analgesia multiple rib fractures |
| title | Erector Spinae Plane Fascial Block in Multiple Rib Fractures (Case Report) |
| title_full | Erector Spinae Plane Fascial Block in Multiple Rib Fractures (Case Report) |
| title_fullStr | Erector Spinae Plane Fascial Block in Multiple Rib Fractures (Case Report) |
| title_full_unstemmed | Erector Spinae Plane Fascial Block in Multiple Rib Fractures (Case Report) |
| title_short | Erector Spinae Plane Fascial Block in Multiple Rib Fractures (Case Report) |
| title_sort | erector spinae plane fascial block in multiple rib fractures case report |
| topic | fascial block erector spinae muscle analgesia multiple rib fractures |
| url | https://www.reanimatology.com/rmt/article/view/1964 |
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