Surgical Stabilization of Rib Fractures While Awake or Under Appropriate Sedation by Paravertebral Block
Study Details
Study Description
Brief Summary
Tracheal intubation and general anesthesia has been considered a safe and conventional routine methodology for thoracic surgery, include multiple rib fratcure. However,adverse effects such as sore throat, pain, hoarseness, and respiratory complications are common after that. In this study, we decide to perform surgical stabiliazation of rib fractures by paravertebral block surgical stabiliazation of rib fractures under awake or appropriate sedation without endotracheal intubation keeping spontaneous respiration to investigate its safety and feasibility.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
Rib fracture is common in the world,especially in chest trauma. Conservative treatment is used to it for many years but the effect is not well because of continuous pain caused by the dislocation of broken rib. Surgical stabiliazation of rib fractures can relieve the pain rapidly and help patient recover to work early. This kind of surgery is constantly conducted with tracheal intubation and general anesthesia. However,adverse effects such as sore throat, pain, hoarseness, and respiratory complications are common after that. So we think perform surgical stabiliazation of rib fractures under awake or appropriate sedation without endotracheal intubation keeping spontaneous respiration to investigate its safety and feasibility.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Paravertebral block in surgical stabilization of rib fractures under awake or appropriate sedation patients receive internal fixation for multiple rib fractures using paravertebral nerve block anesthesia in awareness status and keep spontaneous breath |
Procedure: internal fixation of mulitiple rib fracture
The dislocated rib fracture was anatomically reduced, and then fixed with appropriate equipment to prevent the fracture from being displaced again
|
Outcome Measures
Primary Outcome Measures
- conversion to tracheal intubation [during surgery]
index of consciousness(IOC): If the scale low zhan 40 or high than 60, it need intubation
- pain score [6 hours after operation]
Numerical Rating Scale(NRS): 0-10 is used to represent different degrees of pain, 0 is painless and 10 is severe pain. The grading criteria of pain were: 0: no pain; 1-3: mild pain; 4-6: moderate pain; 7-10: severe pain
- pain score [12 hours after operation]
Numerical Rating Scale(NRS): 0-10 is used to represent different degrees of pain, 0 is painless and 10 is severe pain. The grading criteria of pain were: 0: no pain; 1-3: mild pain; 4-6: moderate pain; 7-10: severe pain
- pain score [24 hours after operation]
Numerical Rating Scale(NRS): 0-10 is used to represent different degrees of pain, 0 is painless and 10 is severe pain. The grading criteria of pain were: 0: no pain; 1-3: mild pain; 4-6: moderate pain; 7-10: severe pain
Secondary Outcome Measures
- operation time [during surgery]
operation time
- blood loss [during surgery]
blood loss
- days of stay hospital [from the date of hospitalization to the date of leave hospital,assessed up to 100 months]
days of stay hospital
- costs of stay hospital [from the date of hospitalization to the date of leave hospital,assessed up to 100 months]
costs of stay hospital
- PONV score [6 hours after operation]
Visual analogue scale (VAS). 1-10 is used to represent different degrees of nausea and vomiting. 1 ~ 4 was mild, 5 ~ 6 was moderate, 7 ~ 10 was severe
- PONV score [12 hours after operation]
Visual analogue scale (VAS). 1-10 is used to represent different degrees of nausea and vomiting. 1 ~ 4 was mild, 5 ~ 6 was moderate, 7 ~ 10 was severe
- PONV score [24 hours after operation]
Visual analogue scale (VAS). 1-10 is used to represent different degrees of nausea and vomiting. 1 ~ 4 was mild, 5 ~ 6 was moderate, 7 ~ 10 was severe
Eligibility Criteria
Criteria
Inclusion Criteria:
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Simple rib fracutures patients
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No other truama
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Unilatieral rib fractures
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Total number of rib fractures is less than 5
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At least one rib dislocation
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18-80 years old
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ASA grade I-II
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BMI<30
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Preoperative arterial partial pressure of oxygen > 60mmhg
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Partial pressure of carbon dioxide < 50mmhg
Exclusion Criteria:
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Difficult airway
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History of esophageal reflux
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Myasthenia gravis
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Coagulation disorders
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Gastrointestinal ulcer
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Gastrointestinal bleeding
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Anesthetic drugs allergy history
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Asthma
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Chronic obstructive pulmonary disease
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Pregnant women.
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Shanghai Jiao Tong University Affiliated Sixth People's Hospital | Shanghai | Shanghai | China | 20030 |
Sponsors and Collaborators
- Shanghai Jiao Tong University Affiliated Sixth People's Hospital
Investigators
- Study Chair: Yi Yang, Shanghai Jiao Tong University affiliated 6th people's hospital
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 2020-036-(1)