Erector spinae plane block for pain management in blunt chest trauma in military prehospital medicine, an interventional study

Basyouny, Karim Ahmed Ramadan; Abd Elkader, Mohamed Abd Elraaouf; Mahmoud, Maher Fawzy; Abdelhamid, Bassant Mohamed; Waheeb, Mohsen Mohamed Elsayed

doi:TEJA-2024-0078

Erector spinae plane block for pain management in blunt chest trauma in military prehospital medicine, an interventional study

Authors

TEJA-2024-0078

Abstract

Background
Erector spinae plane block (ESPB) was presented in previous studies as a simple and safe technique with an excellent analgesic profile and improvement in respiratory function in multiple rib fractures. The purpose of this study was to investigate the efficiency of performing ESPB in the primary care unit for pain alleviation for individuals with blunt chest traumas.
Methods
This prospective interventional work was performed on 54 patients ranging in age from 20 to 50 years old, both sexes, American society of anesthesiology class I and II diagnosed with multiple rib fracture following blunt chest trauma. ESPB were performed using 20 mL of 0.25% levo-bupivacaine.
Results
The median (IQR) numeric rate scale was 9 (8–9) before block application and was significantly reduced to 1 (0–1) till it was 0 (0–1) in the 12th hour. After 24th hour, the median pain score was 2 (1–2), ( < 0.00). The mean arterial blood pressure and heart rate have significantly decreased following the block. Regarding complications of morphine, two patients only experienced mild vomiting. There were no other complications (local anesthetic toxicity, hematoma formation and pneumothorax).
Conclusion
Prehospital administration of ESPB for blunt chest trauma improved the pain scores, decreased the opioid administration without negative consequences on the hemodynamic state or occurrence of complications among participants.

Keywords