Sukumaran Nair Sreekumar, Ranitha Ravindranath, Anju Mariam Jacob
BACKGROUND: Multiple fracture ribs following trauma is one of the common problems managed in a surgical casualty. Pain in rib fracture can be managed by different modes of analgesia. Superior analgesia provides superior improvement in lung compliance after rib fracture thereby reducing morbidity and mortality due to secondary pulmonary complications. METHODS Patients with evidence of rib fracture who received intercostal nerve block along with non-opioid drugs were grouped into Group A and those who received non-opioid drugs alone were grouped into Group B. The effect on pain score and lung compliance were measured by using Visual Analogue Scale and a respirometer respectively before therapy, soon after therapy, 12 hours after therapy and 24 hours later (in both groups). RESULTS In patients who received both intercostal nerve block as well as non-opioid therapy, the pain score decreased, and respirometer score increased progressively. In patients who received non-opioid therapy alone, only a mild decrease in pain score and mild increase in respirometer score till 12 hours and even worsening of mean score 24 hours post therapy were noted. Also, the incidence of development of pulmonary complications of rib fractures was significantly low in the former group compared to the latter. CONCLUSIONS Intercostal nerve block along with non-opioid drugs provide superior pain relief compared to that provided by non-opioid drugs alone in patients suffering from rib fracture. Lung compliance was better and complications lesser in patients who received intercostal nerve block.
