Current Clinical Trials

Ultrasound-Guided Serratus Anterior Plane Block for Thoracic Trauma: Impact on Opioid Reduction, Morbidity, and Mortality
  1. Ami Kurzweil, MD
    Ami Kurzweil, MD
  2. for people 18 and above and up (full criteria)
  3. Rancho Mirage, CA
  4. study started June 2023
  5. Ami Kurzweil, MD
  6. Accepting new patients

Description

Summary

The purpose of this research study is to examine if the Serratus Anterior Plane Block (SAPB) is practical, safe and effective for thoracic trauma (traumatic injury to the chest). Patients that agree to take part, will be randomly assigned to receive standard of care treatment (medical treatment that is considered proper care for a condition) with opioid medication/ epidural catheter placement by anesthesia or a physician will perform a Serratus Anterior Plane Block (SAPB) using ultrasound guidance to inject pain medication in the chest wall. Researchers will record information from the medical record, such as blood pressure and heart rate, and pain scores during the patient's hospital stay. Detailed description: This is a prospective randomized interventional study on a convenience sample of adult patients who present to the emergency department with thoracic trauma with indication for serratus anterior plane nerve block. In this prospective randomized controlled study, patients will be selected into the control or investigation cohort for pain control. The control group will receive standard care which will be divided into two groups: systemic opioid administration or epidural catheter placement by anesthesia both of which is the standard of care at this institution. Patients will be randomized utilizing a research randomizer application which will place each enrolled patient in group 1 (control) or group 2 (intervention) for a total of 150 enrollments. Patients will be enrolled in the study only when there is an available emergency physician who has been trained in ultrasound guided SAPB in the emergency department to perform the nerve block procedure. Investigation cohort patients will undergo point-of-care ultrasound using an emergency department ultrasound machine with linear transducer performed by a physician, guiding the administration of the anesthetic to achieve the desired plane block and numbing of the thoracic wall. A small gauge (18-24g) lumbar puncture needle is attached to a 30cc syringe. The syringe is usually filled with 20cc of Bupivacaine. The muscles and landmarks are localized under ultrasound. When ready, the skin is prepped with alcohol swab or chloraprep. The needle tip is then guided under ultrasound with continuous visualization of the needle to the facial plane between the serratus anterior muscle and the latissimus dorsi muscle. The 20cc bolus is then administered in this space and the needle is removed.

Official Title

Ultrasound-Guided Serratus Anterior Plane Block for Thoracic Trauma: Impact on Opioid Reduction, Morbidity, and Mortality

Keywords

Thoracic trauma

Eligibility

for people 18 and above and up
Approximately 150 adult participants with indications for serratus anterior plane block, will be enrolled in this study. Potential subjects are informed that regardless of their decision on whether or not to participate, their care received from their physician will not be affected. Inclusion Criteria: 1. Over 18 years of age 2. Patient presenting with thoracic trauma including rib fractures, pulmonary contusion, hemothorax, pneumothorax. 3. Able to provide informed consent E... more
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Approximately 150 adult participants with indications for serratus anterior plane block, will be enrolled in this study. Potential subjects are informed that regardless of their decision on whether or not to participate, their care received from their physician will not be affected.

Inclusion Criteria:

1. Over 18 years of age

2. Patient presenting with thoracic trauma including rib fractures, pulmonary contusion, hemothorax, pneumothorax.

3. Able to provide informed consent

Exclusion Criteria

1. Patients under the age of 18.

2. Patients who are intubated

3. Patients who are not able to verbalize pain score secondary to their underlying pathology

4.Patients who are pregnant

5. Patients with a medical contraindication to Serratus Anterior Plane Block (SAPB), i.e. allergy to anesthetic

6 Patients with impaired decision-making capacity.

7. Patients cannot receive a nerve block over existing superficial skin infection

8. Chronic pain syndrome patients who are currently being treated with chronic opioids.

Lead Scientist at Eisenhower Health

Ami Kurzweil, MD

Clinical Study Details

  1. Accepting new patients
  2. study started June 2023
  3. Interventional Prospective Randomized Control trial
  4. April 24, 2024