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The following is a summary of “Ultrasound-guided thoracic nerve blocks for emergency department patients with rib fractures: A review,” published in the January 2025 issue of Emergency Medicine by Hussein et al.
Rib fractures were commonly managed in the emergency department (ED), where ultrasound-guided anesthesia and early pain control improved outcomes with minimal complications.
Researchers conducted a retrospective study to describe thoracic nerve block options for rib fractures and thoracic pain, outlining advantages, risks, and procedural steps.
They searched PubMed, Embase, and Cochrane on April 1, 2024, for studies on “ED thoracic nerve blocks”, 2 reviewers (an emergency medicine ultrasound fellowship-trained attending physician and emergency ultrasound fellow) independently screened 257 titles and abstracts for eligibility, resolving disagreements through a 3rd reviewer. After excluding 1 duplicate, 256 full-text articles were assessed, with 38 research studies meeting the inclusion criteria.
The results showed 256 articles were identified from PubMed (91), Embase (142), and Cochrane reviews (24). After excluding 218 articles based on title and abstract (including 1 duplicate), 38 articles were selected for full manuscript analysis. All 38 met the inclusion and exclusion criteria. Additionally, 5 of 16 extra Cochrane reviews were included.
Investigators concluded the thoracic nerve blocks (e.g., ESP, SANB, ICNB) could be safely performed by trained emergency physicians, offering effective anesthesia for rib fractures and thoracic trauma while improving patient outcomes and reducing complications from opioids and delirium-inducing medications.
Source: sciencedirect.com/science/article/abs/pii/S0736467924002397
