Effect of Intercostal Nerve Block with 0.5% Bupivacaine on Peak Expiratory Flow Rate and Arterial Oxygen Saturation in Rib Fractures

Abstract

Significant increases in Sao2 and PEFR occur after ICNB with 0.5% bupivacaine, which also provides sustained analgesia, leading to improvement in respiratory mechanics.

Postoperative Pain and Other Acute Pain Syndromes

“…These blocks have been shown to improve oxygenation and respiratory mechanics and offer pain relief that is comparable to that of epidural analgesia. 467,468 The technique is limited by the relatively large doses of local anesthetic required; the relatively high intravascular uptake from the intercostal space increases the risk for local anesthetic toxicity. The most common complication associated with this technique is pneumothorax (occurring at an incidence of 1.4% per individual nerve block and in 5.6% of patients with multiple blocks for multiple rib fractures).…”

Postoperative Pain and Other Acute Pain Syndromes

“…These blocks have been shown to improve oxygenation and respiratory mechanics, and offer pain relief that is comparable to that of epidural analgesia. 301,302 The intercostal block technique involves the palpation of the ribs, and injection of local anesthetic proximally to the fracture site. Because of overlapping innervation, the intercostal nerves above and below the fracture site should be blocked as well.…”

Pain management and regional anaesthesia in the trauma patient

“…Intercostal block (ICB) is relatively simple to perform and is effective for pain management in rib fractures [13 ]. ICB is suitable for initial pain control but is limited in its analgesic duration, which is reported to last 4-6 h [40], unless a continuous catheter technique is used.…”