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Master Thesis

Comparison of continuous erector spinae plane block with continuous para-vertebral block for pain management in patients with ribs fracture: a prospective randomised study

Abstract : Background: the control of pain is the cornerstone of patient’s management with multiple ribs fractures. Ribs fractures are indeed associated with significant morbi-mortality. Epidural analgesia or Paravertebral Block (PVB) are proven to be efficient in pain management but these techniques may be provider major adverse event. Erector Spinae Plan (ESP) block may be a credible alternative. The main goal of our study was to compared the efficacy of continuous erector spinae plan block with Paravertebral Block and IV opioid analgesia alone in cumulative morphine consumption. Methods: a prospective, randomized comparative clinical study was conducted. A total of 76 patients were enrolled, who were randomized to either ESP block, PVB group and control group. The primary endpoint was the cumulative morphine consumption 24 h after randomization. Secondary endpoints were analysis of visual analogue scale scores during cough, sniff test values and outcomes. Results: the cumulative morphine consumption 24 hours after ICU admission (primary outcome measure) was not significantly lower in the ESP Block group and in the PVB group compared to the control group, (respectively 17.0 mg [13.0 – 35.0] vs 18.0 mg [12.0 – 35.0] vs 30.5 mg [15.0 – 59.0], p=0,07). The use of ESP Block was also significantly non inferior to PVB according to the primary outcome, p=0,004. Conclusion: the use of the ESP block seems to reduce the consumption of morphine. A lack of statistical power prevents us from achieving the significance of the results. ESP may be a strong alternative to PVB.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03440938
Contributor : Faculté de Médecine Um Connect in order to contact the contributor
Submitted on : Friday, January 7, 2022 - 12:59:43 PM
Last modification on : Tuesday, January 11, 2022 - 3:12:55 AM

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Florène Airoldi. Comparison of continuous erector spinae plane block with continuous para-vertebral block for pain management in patients with ribs fracture: a prospective randomised study. Human health and pathology. 2021. ⟨dumas-03440938⟩

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