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Emergency, Surgery



•Trauma is a major cause of morbidity and mortality worldwide. Rib fractures are identified in at least 10% of all injured patients.

•Rib fractures can lead to significant respiratory complications, with pneumonia and respiratory failure occurring in up to 31% of patients with rib fractures. Early initiation of aggressive pain control and pulmonary hygiene with incentive spirometry are standard of care to prevent complications from developing.

•In the Emergency Department, patients with rib fractures typically receive systemic analgesia that is largely narcotic-based. This pain control strategy puts patients at risk for the side effects of narcotics such as constipation, delirium, and opioid addiction.

•Regional ultrasound-guided anesthesia is well within the purview of emergency physicians and offers a safe and effective alternative to systemic pain medications. A regional block known as the Serratus Anterior Plane Block (SAPB) was described in the anesthesia literature in 2013 as a strategy for improving pain related to rib fractures.

•The literature evaluating the effectiveness of the SAPB is limited to case reports with a small number of patients (n = 1-6). No published studies have assessed incentive spirometry performance in patients who have received the SAPB, described the systemic analgesia required by patients who have received the SAPB, or formally evaluated the safety of the SAPB.


Lambrew Research Retreat



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