Investigation of the effect of intercostal blockade in palliation of pain in patients with rib fracture

Background: This study aims to investigate the effect of intercostal nerve blockade on pain in patients with rib fracture and its effect in reducing the opioid use requirement. Methods: Between August 2008 and July 2010, 120 patients with rib fractures in Antakya State Hospital and Mustafa Kemal University, Faculty of Medicine were included in this clinical randomized prospective study. Patients were divided into two groups. Group 1 (n=60) received tramadol (200 mg/day) and lornoxicam (8 mg/day). In group 2 (n=60), intercostal nerve blockade (0.5% bupivakain 3 ml) was performed in addition to tramadol (50 mg/day) and lornoxicam (8 mg/day) treatment. Scores of patient satisfaction visual analogue scale (VAS) were recorded both at rest and during coughing. At the end of 24 hours, total amount of tramadol used and the number of analgesic demands were recorded. Results: No statistically significant difference in VAS scores between the two groups was observed (p<0.05). However, the amount of tramadol used and the number of analgesic demand were significantly lower in the intercostal nerve blockade group (p<0.05). Conclusion: We concluded that intercostal blockade in the pain management in patients with rib fractures was effective in decreasing the dosage of opioid and thus reducing side effects which might occur.