Comparison of Continuous Intravenous Lidocaine Infusion Versus ESP Block

Status Not yet recruiting

Clinical Trial Summary

Recently in 2016, a new interfascial plane nerve block was developed for thoracic analgesia known as the erector spinae plane block (ESPB). Since its development for thoracic neuropathic pain, the ESPB has been shown to be effective in pain control in multiple procedures including thoracotomies. However, there have been a few published case reports of using ESPB for analgesia in rib fracture management and only one retrospective study which demonstrated improved NRS pain scores and increased incentive spirometry volumes (ICV) post-ESPB compared to pre-ESPB values. The goal of this study is to compare the effectiveness of ESPB as an alternative method to the current standard of care at Stanford Health Care (SHC) for pain management in traumatic rib fractures. At the investigator's institution, the current standard of care is intravenous (IV) and enteral multimodal analgesia that consists primarily of opioids and a continuous IV lidocaine infusion. Although IV lidocaine has shown some benefit in improving post-surgical pain scores, evidence for its use in MRF is lacking. The purpose of this study is to perform a randomized clinical trial comparing outcomes in pain control and incentive spirometry volumes between continuous ESPB catheters and IV lidocaine infusions in adult patients with acute traumatic rib fractures. The investigators want to determine if ESPB can provide improved pain control in patients admitted for traumatic rib fractures compared to IV Lidocaine. The aim is to evaluate the clinical effectiveness of ESPB on OME consumption, pain scores, incentive spirometry volumes, cough strength, respiratory complications, inflammatory biomarkers and hospital LOS. Findings from this study can help improve analgesia, quality of care, and patient satisfaction at Stanford Healthcare and for other acute pain and trauma surgery providers. The aim of this study involves pain management for patients with acute traumatic rib fractures and therefore must involve human subjects.

Clinical Trial Description

n/a

Study Design

Related Conditions & MeSH terms

Clinical Trial Details

NCT number	NCT04707183
Study type	Interventional
Source	Stanford University
Contact	Ban Tsui, MD
Phone	(650) 200-9107
Email	bantsui@stanford.edu
Status	Not yet recruiting
Phase	Phase 2
Start date	March 2024
Completion date	December 2024

View Details

See also
Status	Clinical Trial	Phase
Recruiting	`NCT04554186` - Serratus Anterior Plane Block Versus Thoracic Paravertebral Block.	N/A
Completed	`NCT02432456` - Ketamine Infusion Therapy for the Management of Acute Pain in Adult Rib Fracture Patients	Phase 4
Recruiting	`NCT04413799` - PVB vs Ketamine/Lidocaine in Rib Fracture Patients	Early Phase 1
Completed	`NCT05770232` - Retrospectively Analyze the Risk Factors of VTE in 5774 Patients With Thoracic Trauma From 33 Hospitals in China, and Established a Risk Prediction Model
Completed	`NCT03305666` - Trial of Injected Liposomal Bupivacaine vs Bupivacaine Infusion After Surgical Stabilization of Rib Fractures	Phase 4
Completed	`NCT03768193` - Deep Serratus Anterior Plane Block vs Surgically-placed Paravertebral Block for VATS Surgery	N/A
Recruiting	`NCT05865327` - UltrasouNd-guided Percutaneous Intercostal Nerve Cryoneurolysis for Analgesia Following Traumatic Rib Fracture	N/A
Recruiting	`NCT04100512` - Oscillating Positive Expiratory Pressure (OPEP) Therapy in Trauma Patients With Multiple Rib Fractures	N/A
Completed	`NCT02608541` - Sheffield Multiple Rib Fractures Study:
Completed	`NCT04168996` - Individualized Discharge Planning in Patients With Rib Fracture	N/A
Recruiting	`NCT05714631` - Lidocaine Patches in Elderly Patients With Traumatic Rib Fractures	Phase 4
Recruiting	`NCT03619785` - US-guided SAPB for Rib Fractures in the ED	Phase 4
Suspended	`NCT03711812` - Serratus Anterior Block and Catheter Use in Rib Fractures in the Emergency Department	N/A
Completed	`NCT05321121` - Dexmedotomidine for Acute Pain Control in Patients With Multiple Rib FracturesRandomized Controlled Trial	Phase 4
Completed	`NCT04863807` - A Retrospective Review of Rib Fracture Pain Management at a London Major Trauma Centre
Withdrawn	`NCT05069961` - Non-Inferiority Study of Erector Spinae Plane Block Compared to Thoracic Epidural in Pain Management of Rib Fractures	N/A
Recruiting	`NCT03919916` - Serratus Plane Block With Parenteral Opioid Analgesia Versus Patient Controlled Analgesia in Rib Fractures	N/A
Terminated	`NCT03805360` - The Erector Spinae Plane Block and Its Effect on Respiratory Status and Pain Management in Rib Fracture Patients	Phase 1
Terminated	`NCT04558281` - Continuous Erector Spinae Plane Blocks for Rib Fractures	Phase 4
Completed	`NCT02132416` - Operative Treatment of Unstable Thoracic Cage Injuries and Chest Wall Deformity in Trauma	N/A

Clinical trials are conducted in a series of steps, called phases - each phase is designed to answer a separate research question.

Phase 1: Researchers test a new drug or treatment in a small group of people for the first time to evaluate its safety, determine a safe dosage range, and identify side effects.
Phase 2: The drug or treatment is given to a larger group of people to see if it is effective and to further evaluate its safety.
Phase 3: The drug or treatment is given to large groups of people to confirm its effectiveness, monitor side effects, compare it to commonly used treatments, and collect information that will allow the drug or treatment to be used safely.
Phase 4: Studies are done after the drug or treatment has been marketed to gather information on the drug's effect in various populations and any side effects associated with long-term use.

Comparison of Continuous Intravenous Lidocaine Infusion Versus ESP Block for Rib Fracture Analgesia — Rib Fract ESP

Clinical Trial Summary

Clinical Trial Description

Study Design

Related Conditions & MeSH terms