Using Erector Spinae Plane Block for Pain Management in Severe Chest Trauma

EffecT of eARly analGesia With Erector Spinae Plane Block to Reduce Ventilation After Severe Chest Trauma: a Randomised Control Open-label Trial.

This study is testing if a new pain relief method called the Erector Spinae Plane block can help people with severe chest injuries feel better and breathe easier.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 400 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: University Hospital, Grenoble (Academic / other)
• Locations: 14 sites (Bordeaux and 13 other locations)
• Trial ID: NCT05920109 on ClinicalTrials.gov

What this trial studies

This clinical trial investigates the effectiveness of the Erector Spinae Plane (ESP) block for managing pain in patients with severe chest trauma, particularly those with multiple rib fractures. The study aims to assess whether early analgesia using the ESP block can reduce the need for mechanical ventilation and improve respiratory outcomes. Patients eligible for the trial include those who are spontaneously breathing or on mechanical ventilation and require intensive care. The trial seeks to provide a safer and more effective alternative to traditional pain management techniques that may have higher risks and complications.

Who should consider this trial

Good fit: Ideal candidates for this study are adults over 18 years old with blunt chest trauma involving three or more rib fractures.

Not a fit: Patients who are not expected to survive within the first 72 hours or have severe hemodynamic instability may not benefit from this study.

Why it matters

Potential benefit: If successful, this approach could significantly improve pain management and respiratory function in patients with severe chest trauma.

How similar studies have performed: While the ESP block is a relatively novel approach, similar studies have shown promising results in pain management, suggesting potential for success in this context.

Eligibility criteria

Inclusion Criteria:

Age \> 18 years

Blunt chest trauma with 3 or more rib fractures on Thoracic CT scan

With spontaneous breathing or under mechanical ventilation in the trauma bay

Requiring an intensive (or intermediate) care unit admission

Exclusion Criteria:

Pre-hospital cardiac arrest

Patient not expected to survive within the first 72 hours

Uncontrolled haemodynamic instability despite initial resuscitation (systolic arterial blood pressure lower than 90 mmHg at the time of catheter insertion)

Mechanical ventilation for severe traumatic brain injury (Abbreviated Injury Score, AIS, head \> 2)

Spinal cord injury at the cervical or thoracic levels

Hypovolaemia.

Hypersensitivity to ropivacaine or other amide-bound local anaesthetics

Subject in exclusion period of another interventional study

Pregnant, breastfeeding women

Where this trial is running

Bordeaux and 13 other locations

• CHU Bordeaux - Pellegrin — Bordeaux, France (Recruiting)
• Hôpital d'instruction des armées Percy — Clamart, France (Recruiting)
• CHU Clermont-Ferrand — Clermont-Ferrand, France (Recruiting)
• Hopital Beaujon - AP-HP — Clichy, France (Recruiting)
• CH Annecy Genevois — Épagny, France (Recruiting)
• CHU Grenoble Alpes — Grenoble, France (Recruiting)
• CHU de Lille — Lille, France (Recruiting)
• Hôpital Pitie Salpetriere - AP-HP — Paris, France (Recruiting)
• Hôpital Européen Georges Pompidou - AH-HP — Paris, France (Recruiting)
• Hôpital Lyon Sud — Pierre-Bénite, France (Recruiting)
• Hôpital d'Instruction des Armées Sainte Anne — Toulon, France (Recruiting)
• Chu Toulouse - Hopital Rangueil — Toulouse, France (Recruiting)
• Chu Toulouse - Hopital Purpan — Toulouse, France (Recruiting)
• CHRU Hôpitaux De Tours — Tours, France (Recruiting)

Study contacts

• Principal investigator: BOUZAT Pierre, MD, PhD — Grenoble Alps University Hospital
• Study coordinator: BOUZAT Pierre, MD, PhD

Conditions Severe Chest Trauma; chest trauma; erector spinae plane block; Pain management