Status:
COMPLETED
Comparison of Epidural and Paracostal Catheter Placement for Pain Control After Rib Fractures
Lead Sponsor:
University of Colorado, Denver
Conditions:
Rib Fractures
Wounds and Injuries
Eligibility:
All Genders
18-99 years
Phase:
NA
Brief Summary
The investigators plan to compare the incidence of successful placement of epidural pain catheters versus paracostal catheters for the control of pain and prevention of pulmonary complications for adu...
Eligibility Criteria
Inclusion
- \>/= 3 rib fractures on a single side
- Admitted to the Surgical ICU
- Recruited within 24 hours of admission
Exclusion
- Patient allergy to local anesthetics
- Patient refusal
- Inability to consent for any reason
- Prisoners
- Age \< 18
- Pregnant women (pregnancy screen performed as part of routine trauma admission labs)
- Absolute contraindications for either thoracic epidural or paracostal pain catheter placement which include:
- Localized rash or skin infection over the likely site of insertion (We never want to translocate infectious material from the skin to the epidural space or even into the soft tissue where paracostal catheters lay, although for these there is more flexibility in adjusting placement)
- Spinal/vertebral instability/fracture including any significant vertebral body injury and 3 or more spinous process fractures near the level of desired epidural placement (transverse process fractures are not considered a contraindication)
- History of extensive back surgery at the level of desired epidural placement
- Severe aortic stenosis, mitral stenosis, or pulmonary hypertension
- Inability to correct coagulopathy (to International Normalized Ratio\>1.5)
- Persistent hemodynamic instability (hypotension with Systolic Blood Pressure\<90 that does not respond to initial fluid boluses and requires ongoing pressors beyond the 72 hour window for enrollment)
- Inability to cooperate and participate in placement (if intubated and sedated, for example) or to lie in the correct position for placement (lateral decubitus for paracostal pain catheters, either sitting up or lateral decubitus for epidural placement)
- Concern for elevated intracranial pressure (we imagine these patients will also be intubated)
Key Trial Info
Start Date :
August 19 2015
Trial Type :
INTERVENTIONAL
Allocation :
ACTUAL
End Date :
June 1 2017
Estimated Enrollment :
36 Patients enrolled
Trial Details
Trial ID
NCT02295098
Start Date
August 19 2015
End Date
June 1 2017
Last Update
June 8 2018
Active Locations (1)
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1
Denver Health Medical Center
Denver, Colorado, United States, 80204