- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03396692
PEF-Block & Ribs Fractures (PEF)
October 14, 2022 updated by: University Hospital, Montpellier
PEF-Block & Ribs Fractures Effect of Posterior Exo-thoracic Fascia Block in the Pain Management of Ribs Fractures: a Prospective, Randomized Study
Rib fractures are frequent injuries found approximately in 10% severe trauma patient.
Rib fractures were correlated in many studies with a higher morbidity and mortality.
This impaired outcome is mainly due to pulmonary complications consequences including especially pulmonary contusions.
Frequently, patients present difficulty deep breathing and coughing.
These adverse effects can lead to the development of atelectasis, hypoxia, and respiratory failure with mechanic ventilation recourse.
Effective pain management may prevent these complications and reduce the likelihood of developing chronic pain.
A multi-modal analgesia regimen is widely employed combining regional and systemic analgesia.
Epidural analgesia is considered by many authors to be the gold standard of pain relief although many side-effects are frequently describe including hypotension, urinary retention nausea and vomiting.
Paravertebral nerve blockade is an adequate alternative that provide similar quality of analgesia with lower incidence of complication.
However, the failure rate associates with PVB is about 13% and it may be associated with hypotension (4.6%), accidental vascular puncture (3.8%), accidental pleural puncture (1.1%) and rarely pneumothorax (0.5%).
Recently, a description of the intercostal paraspinal nerve block.
This technic was performed for patients undergoing thoracic surgery without complications.More recently, a description of a new approach to provide thoracic analgesia named the Posterior Paramedian subchoroidal (PoPS) block.
The authors consider this technique provide an analgesia of the anterior and the posterior branch of adjacent thoracic nerves.
The investigators propose to investigate the effect of Posterior exothoracic fascial block.
Study Overview
Status
Completed
Conditions
Study Type
Interventional
Enrollment (Actual)
90
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
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Montpellier, France, 34295
- University Hospital Center
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Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
16 years to 78 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Major patients (18-80 years old)
- Affiliated to the social security
- Hospitalized following severe trauma associated with at least 2 unilateral ribs fractures
- EVA greater than or equal to 3 when coughing or when mobilizing care.
- Management of the patient in the first 24 hours post trauma.
- Patient not intubated.
- Collection of informed written consent, notification on the anesthesia sheet.
Exclusion Criteria:
- Minor patients,
- Patients under guardianship
- Pregnant or lactating women
- Allergy known to local anesthetics,
- Severe coagulopathy,
- Infection of the puncture site
- Neuromuscular pathology
- Chronic pain patients (long-term treatment with non-inflammatory steroidal, opioid, neuroleptic, antidepressant, antiepileptic),
- Intubated patient
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Control Arm
Pain management use intravenous morphine patient-controlled analgesia (PCA)
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Group 1 control:
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Experimental: Posterior exo-thoracic fascia block arm
Pain management use intravenous morphine patient-controlled analgesia (PCA) and a block of the posterior exo-thoracic fascia with Ropivacaine
|
Group 2 PEF block:
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Experimental: Paravertebral block arm
Pain management use intravenous morphine patient-controlled analgesia (PCA) and a block of paravertebral space with Ropivacaine
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Group 3 paravertebral block:
Possibility of an additional bolus of 0.1ml / kg every hour if insufficient analgesia. In the case of failure of initial management with significant pain despite the iterative boli, epidural analgesia is used in recourse. |
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Consumption of opoïd
Time Frame: 24 hours
|
24 hours
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
cough pain intensity
Time Frame: 1 hour, 6hours, 12hours, 24hours
|
1 hour, 6hours, 12hours, 24hours
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
June 18, 2018
Primary Completion (Actual)
June 15, 2022
Study Completion (Actual)
June 15, 2022
Study Registration Dates
First Submitted
December 15, 2017
First Submitted That Met QC Criteria
January 4, 2018
First Posted (Actual)
January 11, 2018
Study Record Updates
Last Update Posted (Actual)
October 17, 2022
Last Update Submitted That Met QC Criteria
October 14, 2022
Last Verified
October 1, 2022
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- UF 9860
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
No
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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