Analgesic Choice in Management of Rib Fractures: Paravertebral Block or Epidural Analgesia?

Anesthesia and Analgesia
Mahdi MalekpourJeffrey Wild

Abstract

Rib fractures are commonly encountered in the setting of trauma. The aim of this study was to assess the association between the clinical outcome of rib fracture and epidural analgesia (EA) versus paravertebral block (PVB) using the National Trauma Data Bank (NTDB). Using the 2011 and 2012 versions of the NTDB, we retrieved completed records for all patients above 18 years of age who were admitted with rib fractures. Primary outcome was in-hospital mortality. Secondary outcomes were length of stay (LOS), intensive care unit (ICU) admission, ICU LOS, mechanical ventilation, duration of mechanical ventilation, development of pneumonia, and development of any other complication. Clinical outcomes were first compared between propensity score-matched EA and PVB patients. Then, EA and PVB patients were combined into the procedure group and the outcomes were compared with propensity score-matched patients that received neither intervention (no-procedure group). A total of 194,766 patients were included in the study with 1073 patients having EA, 1110 patients having PVB, and 192,583 patients having neither procedure. After propensity score matching, comparison of primary and secondary outcomes between EA and PVB patients showed no diff...Continue Reading

References

Dec 1, 1994·The Journal of Trauma·D W Ziegler, N N Agarwal
Nov 14, 1998·British Journal of Anaesthesia·J Richardson, P A Lönnqvist
Mar 5, 2003·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Serife Tuba LimanSalih Topcu
Mar 14, 2003·The Journal of Trauma·Manoj K Karmakar, Anthony M-H Ho
Apr 15, 2003·Journal of the American College of Surgeons·John B HolcombFrederick A Moore
Aug 10, 2004·Surgery·Eileen M BulgerGregory J Jurkovich
May 28, 2005·The Annals of Thoracic Surgery·Emmanuel MarretFrancis J Bonnet
Nov 5, 2005·Surgery·Benjamin T FlagelRichard L Gamelli
Apr 21, 2006·Critical Care Medicine·Karen J BraselJohn A Weigelt
Jan 18, 2007·JAMA : the Journal of the American Medical Association·Ralph B D'Agostino, Ralph B D'Agostino
May 11, 2007·Best Practice & Research. Clinical Anaesthesiology·Henrik KehletUNKNOWN Prospect Working Group
Apr 5, 2008·Injury Prevention : Journal of the International Society for Child and Adolescent Injury Prevention·B RoudsariR Caetano
May 6, 2008·Anesthesiology Clinics·Niamh P ConlonKatherine P Grichnik
Feb 28, 2009·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·François M CarrierMartin R Lessard
Oct 27, 2009·Interactive Cardiovascular and Thoracic Surgery·Marco ScarciRizwan Attia
Nov 3, 2009·World Journal of Surgery·Julie A EvansZsolt J Balogh
Nov 18, 2011·Journal of Cardiothoracic and Vascular Anesthesia·Hany ElsayedNigel Scawn
Feb 19, 2013·Journal of the American College of Surgeons·Silvana F MarascoMark Fitzgerald
Oct 12, 2013·American Journal of Surgery·Yifan YangGarth H Utter
Jan 25, 2014·The Journal of Trauma and Acute Care Surgery·Niloofar DehghanAvery Nathens
Apr 19, 2015·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Annalise UnsworthStephen Edward Asha
Sep 25, 2015·The Journal of Trauma and Acute Care Surgery·Sarah MajercikThomas W White

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Citations

Jul 19, 2018·Current Opinion in Anaesthesiology·Venkatesan ThiruvenkatarajanSanjib Das Adhikary
Feb 8, 2018·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Jesse PeekMirjam B de Jong
Jan 30, 2019·Current Opinion in Anaesthesiology·Corey Scher, Robert Mansky
Mar 13, 2019·Anaesthesia·K El-Boghdadly, M D Wiles
Mar 16, 2019·Minerva anestesiologica·Federico Franchi, Sabino Scolletta
Aug 19, 2017·Current Opinion in Critical Care·Mathieu CapdevilaXavier Capdevila
Sep 25, 2017·Current Opinion in Anaesthesiology·Elke M E BosPhilipp Lirk
Sep 11, 2020·A&A Practice·John J FinneranBrian M Ilfeld
Mar 1, 2019·Current Opinion in Anaesthesiology·Robert Mansky, Corey Scher
May 22, 2020·Current Anesthesiology Reports·Michelle Kim, James E Moore
Jan 1, 2021·The American Journal of Emergency Medicine·Şeyma TekşenBora Bilal
May 18, 2020·Chinese Journal of Traumatology = Zhonghua Chuang Shang Za Zhi·Bekir Nihat DogrulSelim Can Peker
Jul 10, 2020·A&A Practice·Brian P CurranJohn J Finneran
Jan 23, 2021·International Anesthesiology Clinics·Maeve Muldowney, Paul I Bhalla
May 25, 2021·Anesthesiology Clinics·Robert Vietor, Chester Buckenmaier

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