Non-Inferiority Study of Erector Spinae Plane Block Compared to Thoracic Epidural in Pain Management of Rib Fractures (SUETHE-Ribs)
Not Recruiting
18 years or above
All
Phase
N/A
124 participants needed
Brief description of study
The purpose of this study is to compare 2 pain control treatments for people with 3 or moreb fractures.
Detailed description of study
2.1 Primary Objective
- Compare efficacy of ESPB to TEA for MRF analgesia.
2.2 Secondary Objective
- Compare systemic opioid and non-opioid medication use in patients with ESPB and TEA.
2.3 Tertiary/Exploratory/Correlative Objectives
- Determine improvement in respiratory function in ESPB versus TEA before and aftergesia placement.
- Compare complications that occur in patients who receive ESPB versus TEA.
- Compare dermatome levels relative to catheter placement that achieve analgesia for TEAd ESPB.
- Compare differences in deep vein thrombosis (DVT) prophylaxis and incidence between ESPBd TEA.
- Differences in length of stay (LOS) for TEA versus ESPB.
- Differences in risk of delirium between TEA and ESPB.
- Differences in oxygen and ventilatory support between TEA and ESPB.
- Patient satisfaction of pain management.
Eligibility of study
You may be eligible for this study if you meet the following criteria:
- Conditions: Rib Fractures
-
Age: 18 years or above
-
Gender: All
Inclusion Criteria:
- 18 years or older
- Radiological evidence of 3 or more rib fractures
- Within 48 hours of admission to hospital with rib fractures
- Can actively participate by answering questions during TEA or ESPB placement
- Moderate-severe (4-10 out of 10) pain at the time of enrollment
Exclusion Criteria:
- Greater than 48 hrs since admission to the hospital with rib fractures
- Patient refusal
- Prisoner
- Infection at the site of TEA or ESPB insertion
- Allergy to local anesthetics
- Depth from skin to catheter placement target 6 or more centimeters
- Greater than 7 consecutive ribs involved on each side
- Other regional or epidural block already received
- Unable to follow commands/altered mental status
- Dementia
- Sepsis (temperature > 38 degrees Celsius & positive blood cultures)
- Elevated intracranial pressure (ICP > 12 mm Hg)
- Coagulopathy (INR > 1.4) or recent therapeutic anticoagulant use (varies with whichdication the patient is on)
- Preexisting central nervous system disorders, such as multiple sclerosis
- Thrombocytopenia (Platelets <70,000)
- Spine fracture or previous back surgery
- Preload dependent states (aortic stenosis, hypertrophic obstructive cardiomyopathy)
- Aortic transection
- Hemodynamic instability (patients with MAPs <60 and/or patients requiring pressorupport)
- Tattoo at sight of catheter placement
Updated on
16 Sep 2025.
Study ID: 11414
