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Comparison of Epidural Block and Apotel in Controlling Pain among Patients with Rib Fracture
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| Author:
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SAEID HEIDARI, ALIREZA KAMALI, SIAMAK RAKEI ESFEHANI, MAHMOUD AMINI
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| Abstract:
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Rib fracture is one of the most common traumatic fractures. Chest injuries are the cause of traumatic hospitalization
in 8-15% of patients. Basis of fracture therapy includes pain control, chest physiotherapy and respiratory care. Pain
control can be done in a variety of ways such as intravenous analgesia, and the use of local anesthetics (e.g., topical gel
and nerve blocks). Among the nerve blocks, the most commonly used method is the thoracic epidural block. Venous
acetaminophen (apotel) is one of the most commonly applied drugs to control the pain of patients. we compared the
two methods of treating the thoracic epidural analgesia and apotel in pain management. This double-blind clinical trial
was performed on all patients referred to Vali-e-Asr Hospital, Arak-Iran, with rib fracture. One group received
Marcaine 0.25 at 0.3 cc/kg and the other group received one gram of apotel in 200 ml normal saline. Heart rate and
mean blood pressure and pain were recorded in 15 minutes, 1, 2, 4, 12 and 24 hours after the procedure. Data were
then analyzed by SPSS software. A total of 84 patients entered the study. The mean age was 53.4 ± 3.6 years in the
thoracic epidural group and 51.9 ± 4.5 years in the apotel group. In the thoracic epidural group, 66.6% were male and
33.4% female respectively. In apotel group, 64.8% were male and 35.2% were females. No significant difference was
observed in the mean pain of patients before intervention (P =0.05), but there was a significant difference between 15
minutes, 1, 4 and 12 hours after intervention (P =0.05), Therefore, the pain score in the epidural group was less than
the apotel. In addition, the mean blood pressure in the epidural group was lower than the apotel at 15 minutes after
the intervention (P = 0.01). Furthermore, the mean heart rate in the epidural group was lower than the apotel at 15
minutes and immediately after intervention (P = 0.02). The mean duration of anesthesia was found to be higher in the
epidural group as compared to the apothecary group (P = 0.01), and the length of hospital stay in the apotel was
more than the thoracic epidural group. Based on the findings presented herein, the pain was less in the epidural
group at all times than the apotel, and the duration of analgesia was higher in the thoracic epidural group and the
duration of hospitalization was lower, it is concluded the epidural thoracic method can be used effectively for
reducing the pain in patients with fracture of the rib
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| Keyword:
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Thoracic epidural analgesia, apotel, Rib fracture.
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| EOI:
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| DOI:
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https://doi.org/10.31838/ijpr/2019.11.02.054
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| Download:
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