Eurasian Journal of Emergency Medicine (Jun 2021)
The Effectiveness of the Combined Use of Intravenous Analgesia and Intercostal Nerve Block in Pain Control for Patients with Rib Fractures Admitted to the Emergency Service
Abstract
Aim:Traumatic rib fractures are a common injury in the trauma population and may cause severe pain in cases of both isolated rib fractures and chest injuries. The aim of our study was to compare the early pain control of intercostal block with that of intravenous analgesia + intercostal nerve block in patients with rib fractures admitted to the emergency department due to blunt thoracic trauma.Materials and Methods:Patients admitted to the emergency department due to blunt thoracic trauma in a tertiary medical facility were evaluated retrospectively. Forty-eight patients were included in the study. The patients were divided into two groups: on in which only intercostal nerve block was performed and another in which intravenous analgesia + intercostal block were performed concurrently.Results:Nine patients (18.7%) were given only intercostal block, while 39 patients (81.3%) were given intravenous analgesia + intercostal nerve block. Considering the early pain results of group A (intercostal nerve block) and group B (intravenous analgesia + intercostal nerve block), significant improvement was observed in group B in terms of pain results after the first 15 minutes.Conclusion:We conclude that the combination of intravenous nonsteroidal anti-inflammatory drugs or opioid derivatives and intercostal nerve block would be an effective combination in pain control in patients with rib fractures. In addition, intercostal nerve block would be beneficial in pain control and increase respiratory efficiency in patients with rib fractures, since it is both easy to apply and accelerates healing by providing effective analgesia. Due to these positive effects, we believe that it reduces the duration of hospital stay and would offer great advantages in terms of efficiency and cost.
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