I. V. Alfentanil Analgesia for Physiotherapy Following Rib Fractures

Abstract

A case is presented in which intermittent i.v. alfentanil was titrated to meet the analgesic requirements in a patient with extensive rib fractures, during each session of intensive chest physiotherapy. This method of analgesia is discussed and compared with other analgesic techniques.

Active cycle of breathing techniques contributes to pain reduction in patients with rib fractures

“…Overall, it appeared that pain reduced faster and in a similar pattern for participants in the experimental group compared with participants in the control group who, in turn, experienced ups and downs in their experience of pain reduction. Many studies have shown the effectiveness of analgesics given for pain control in patients with rib fractures [5,7,29]. In the present study, it appeared that the active cycle of breathing techniques (ACBT) reduced the level of pain.…”

“…Adequate analgesia and effective physiotherapy are all essential components in the management of rib fractures if complications are to be avoided [4,5,6,7]. To this end, a variety of physiotherapy techniques (positioning, early mobilization, effective cough, the active cycle of breathing techniques (ACBT) and incentive spirometer training), is widely used [2,8,9,10].…”

Chest Trauma: Current Recommendations for Rib Fractures, Pneumothorax, and Other Injuries

“…Historically, systemic opioids have been used as first-line agents to alleviate pain resulting from multiple rib fractures. Administration via oral, intravenous (intermittent, continuous, and patient-controlled analgesia), intramuscular, transdermal, and nebulized routes have all proven effective [2][3][4][5][6][7]. Mackersie et al found that continuous infusion of intravenous fentanyl improved visual analog pain scores and vital capacity.…”

Analgesia for manipulation of the knee

“…3 We believe that the Fenem FEF carbon dioxide detector provides useful additional information so that inappropriate life-threatening oesophageal intubation can be rapidly detected. It should be available wherever intubations are attempted.…”