Improved Outcomes Associated with the Liberal Use of Thoracic Epidural Analgesia in Patients with Rib Fractures

Pain Medicine ◽  
2016 ◽  
pp. pnw199 ◽  
Author(s):  
Courtney D. Jensen ◽  
Jamie T. Stark ◽  
Lewis L. Jacobson ◽  
Jan M. Powers ◽  
Michael F. Joseph ◽  
...  
Keyword(s):  
Epidural Analgesia ◽  
Rib Fractures ◽  
Thoracic Epidural Analgesia ◽  
Thoracic Epidural ◽  
Improved Outcomes

scholarly journals Effect of Thoracic Epidural Analgesia in Patients of Traumatic Multiple Rib Fractures withNeurotrauma: A Study Done in a SpecializedNeuro-ICU in Bangladesh

2020 ◽  
Vol 6 (1) ◽  
pp. 24-28
Author(s):  
SM Ahsanul Habib ◽  
Lutful Aziz ◽  
Arifa Sultana ◽  
Taneem Mohammad ◽  
Kaisar Haroon
Keyword(s):  
Epidural Analgesia ◽  
Distress Syndrome ◽  
Rib Fractures ◽  
Thoracic Epidural Analgesia ◽  
Pain Rating ◽  
Analgesic Drug ◽  
Multiple Rib Fractures ◽  
Thoracic Epidural ◽  
Chest Expansion ◽  
Length Of Icu Stay

analgesic administration as well as between early and delayed epidural analgesia. Monitoring was done to identify if any complications occur either due to the procedure or anaesthetic or analgesic drug itself. Results: A total number of 100 patients were recruited for this study. Following thoracic epidural analgesia (TEA), pain rating improved in 76.0% cases; coughing was diminished in 78.0% cases, while suctioning was improved in 68.0% cases. Besides, physiotherapy and positioning improvement were found in 68.0% cases and 72.0% cases respectively, while chest expansion was improved in 88.0% cases. Thoracic epidural analgesia was given soon after injury and had given a significant improvement compared with the patients who got the delayed TEA considering in ventilation (78.0% vs. 22.0%) and in mobilization (72.0% vs. 32.0%)(p<0.001); however, weaning from the ventilator or length of ICU stay had no difference among those two groups. Moreover, pneumonia, acute respiratory distress syndrome (ARDS) and mortality reported more in those who got delayed TEA(p<0.05). Complications included the misplacement of catheter (2.0%), hypotension (8.0%), bradycardia (6.0%) and respiratory depression (2.0%). Conclusion: Thoracic epidural analgesia which is given soon after injury has showed better prognosis and outcomes in the patients suffering from multiple rib fractures with neurotrauma. Journal of National Institute of Neurosciences Bangladesh, 2020;6(1): 24-28

Posterior paramedian subrhomboidal analgesia versus thoracic epidural analgesia for pain control in patients with multiple rib fractures

2016 ◽  
Vol 81 (3) ◽  
pp. 463-467 ◽  
Author(s):  
Casey L. Shelley ◽  
Stepheny Berry ◽  
James Howard ◽  
Martin De Ruyter ◽  
Melissa Thepthepha ◽  
...  
Keyword(s):  
Epidural Analgesia ◽  
Pain Control ◽  
Rib Fractures ◽  
Thoracic Epidural Analgesia ◽  
Multiple Rib Fractures ◽  
Thoracic Epidural

Paravertebral Block versus Thoracic Epidural Analgesia for Postthoracotomy Pain Relief: A Meta-Analysis of Randomized Trials

2021 ◽  
Author(s):  
Mu Xu ◽  
Jiajia Hu ◽  
Jianqin Yan ◽  
Hong Yan ◽  
Chengliang Zhang
Keyword(s):  
Side Effects ◽  
Pain Relief ◽  
Epidural Analgesia ◽  
Meta Analysis ◽  
Thoracic Epidural Analgesia ◽  
Paravertebral Block ◽  
Cochrane Library ◽  
Thoracic Epidural ◽  
Analgesic Consumption ◽  
Postthoracotomy Pain

Abstract Objective Paravertebral block (PVB) and thoracic epidural analgesia (TEA) are commonly used for postthoracotomy pain management. The purpose of this research is to evaluate the effects of TEA versus PVB for postthoracotomy pain relief. Methods A systematic literature search was conducted in PubMed, EMBASE, Web of Science, and the Cochrane Library (last performed on August 2020) to identify randomized controlled trials comparing PVB and TEA for thoracotomy. The rest and dynamic visual analog scale (VAS) scores, rescue analgesic consumption, the incidences of side effects were pooled. Results Sixteen trials involving 1,000 patients were included in this meta-analysis. The pooled results showed that the rest and dynamic VAS at 12, 24, and rest VAS at 48 hours were similar between PVB and TEA groups. The rescue analgesic consumption (weighted mean differences: 3.81; 95% confidence interval [CI]: 0.982–6.638, p < 0.01) and the incidence of rescue analgesia (relative risk [RR]: 1.963; 95% CI: 1.336–2.884, p < 0.01) were less in TEA group. However, the incidence of hypotension (RR: 0.228; 95% CI: 0.137–0.380, p < 0.001), urinary retention (RR: 0.392; 95% CI: 0.198–0.776, p < 0.01), and vomiting (RR: 0.665; 95% CI: 0.451–0.981, p < 0.05) was less in PVB group. Conclusion For thoracotomy, PVB may provide no superior analgesia compared with TEA but PVB can reduce side effects. Thus, individualized treatment is recommended. Further study is still necessary to determine which concentration of local anesthetics can be used for PVB and can provide equal analgesic efficiency to TEA.

scholarly journals Thoracic epidural analgesia improves lung function in CABG patients

2005 ◽  
Vol 52 (S1) ◽  
pp. A48-A48 ◽  
Author(s):  
Paul K. Tenenbein ◽  
Doug Maguire ◽  
Roland Debrouwere ◽  
Peter C. Duke ◽  
Stephen E. Kowalski
Keyword(s):  
Lung Function ◽  
Epidural Analgesia ◽  
Thoracic Epidural Analgesia ◽  
Thoracic Epidural ◽  
Cabg Patients
Sign in / Sign up

Export Citation Format

Share Document