Paravertebral Block In Rib Fractures Memduh Yetim MD, Sukru Tekindur MD, Y. Emrah Eyi MD PII: DOI: Reference:
S0735-6757(15)00035-2 doi: 10.1016/j.ajem.2015.01.033 YAJEM 54762
To appear in:
American Journal of Emergency Medicine
Received date: Accepted date:
17 January 2015 19 January 2015
Please cite this article as: Yetim Memduh, Tekindur Sukru, Eyi Y. Emrah, Paravertebral Block In Rib Fractures, American Journal of Emergency Medicine (2015), doi: 10.1016/j.ajem.2015.01.033
This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
ACCEPTED MANUSCRIPT Paravertebral Block In Rib Fractures
RI PT
Memduh Yetim MD1, Sukru Tekindur MD,2, Y. Emrah Eyi MD3 1
Van Military Hospital, Van, TURKEY
2
Gulhane Military Medical Academy (GMMA) Department of Anesthesiology and
Gulhane Military Medical Academy (GMMA) Department of Emergency Medicine,
NU
3
SC
Reanimation, Ankara, TURKEY
Corresponding Author: Memduh Yetim MD;
MA
Ankara, TURKEY
PT ED
E-mail: [email protected], telephone: +90-532-204-6799
fax: +90-312-456-1194, Address:
AC
Keywords:
CE
Van Military Hospital, Tusba, Van, Turkey
Analgesia, Paravertebral block, Rib Fractures
Word Count: 214 (Manuscript);
ACCEPTED MANUSCRIPT Paravertebral Block In Rib Fractures Dear Editor, We read the article “A modified paravertebral block to reduce risk of mortality in a
RI PT
patient with multiple rib fractures” written by Hitoshi Yoshida and cols. with a great interest.[1] They disclose that retrolaminar block (RB)/costovertebral canal block (CVCB) can be applicable at multiple rib fractures with coagulopathy. We would like
SC
to thank the authors for their contribution. We believe that these findings will enlighten further studies about the concentrations of paravertebral block in emergency room and also at post-operative analgesia.
bleeding may occur in the
NU
Major complications including rib fractures, pneumothorax, esophageal injuries and thoracic trauma cases admitted to the emergency
MA
department.[2,3,4] Even if isolated rib fractures or fractures may not be early mortal, it may be mortal lately because of secondary pneumonia due to pain.[5] Treatment
PT ED
methods for pain are mainly NSAİD, opioid analgesics, thoracic epidural analgesia and paravertebral block (PVB). PVB is an effective method in rib fractures but PVB is providing only ipsilateral segmental thoracic analgesia.[6] Finally, we think that retrolaminar block is very usefull technique for pain relief with
CE
safety for other tecniques. But paravertebral block is effective at the block side and segmental. For this reason it isn’t very practical at multi-location pain like multiple
AC
rib fractures.
[1] Yoshida H, et al, A modified paravertebral block to reduce risk of mortality in a patientwith
multiple
rib
fractures,
Am
J
Emerg
Med
(2014),
http://dx.doi.org/10.1016/j.ajem.2014.10.032 [2] Chen CL, Cheng YL. Delayed massive hemothorax complicating simple rib fracture associated with diaphragmatic injury. Am J Emerg Med. 2014 Jul;32(7):818.e3-4. doi: 10.1016/j.ajem.2013.12.060. Epub 2014 Jan 7.
ACCEPTED MANUSCRIPT [3] Sekizawa A1, Yanagawa Y, Nishi K, Takasu A, Sakamoto T. A case of thoracic degloving injury with flail chest. Am J Emerg Med. 2011 Sep;29(7):841.e1-2. doi:
RI PT
10.1016/j.ajem.2010.06.021. Epub 2010 Oct 8. [4] Kouritas VK1, Matheos E, Baloyiannis I, Spyridakis M, Desimonas N, Hatzitheofilou
SC
K. Late presentation of jejunal perforation after thoracic trauma. Am J Emerg Med.
NU
2009 Nov;27(9):1177.e1-3. doi: 10.1016/j.ajem.2009.02.018. [5] Battle CE, Hutchings H, Evans PA. Risk factors that predict mortality in patients
MA
with blunt chest wall trauma: a systematic review and meta-analysis. Injury 2012 Jan;43(1):8-17.
AC
CE
Aug;81(2):230-8
PT ED
[6] Richardson J, Lönnqvist PA. Thoracic paravertebral block. Br J Anesth 1998
S0735-6757(15)00035-2 doi: 10.1016/j.ajem.2015.01.033 YAJEM 54762
To appear in:
American Journal of Emergency Medicine
Received date: Accepted date:
17 January 2015 19 January 2015
Please cite this article as: Yetim Memduh, Tekindur Sukru, Eyi Y. Emrah, Paravertebral Block In Rib Fractures, American Journal of Emergency Medicine (2015), doi: 10.1016/j.ajem.2015.01.033
This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
ACCEPTED MANUSCRIPT Paravertebral Block In Rib Fractures
RI PT
Memduh Yetim MD1, Sukru Tekindur MD,2, Y. Emrah Eyi MD3 1
Van Military Hospital, Van, TURKEY
2
Gulhane Military Medical Academy (GMMA) Department of Anesthesiology and
Gulhane Military Medical Academy (GMMA) Department of Emergency Medicine,
NU
3
SC
Reanimation, Ankara, TURKEY
Corresponding Author: Memduh Yetim MD;
MA
Ankara, TURKEY
PT ED
E-mail: [email protected], telephone: +90-532-204-6799
fax: +90-312-456-1194, Address:
AC
Keywords:
CE
Van Military Hospital, Tusba, Van, Turkey
Analgesia, Paravertebral block, Rib Fractures
Word Count: 214 (Manuscript);
ACCEPTED MANUSCRIPT Paravertebral Block In Rib Fractures Dear Editor, We read the article “A modified paravertebral block to reduce risk of mortality in a
RI PT
patient with multiple rib fractures” written by Hitoshi Yoshida and cols. with a great interest.[1] They disclose that retrolaminar block (RB)/costovertebral canal block (CVCB) can be applicable at multiple rib fractures with coagulopathy. We would like
SC
to thank the authors for their contribution. We believe that these findings will enlighten further studies about the concentrations of paravertebral block in emergency room and also at post-operative analgesia.
bleeding may occur in the
NU
Major complications including rib fractures, pneumothorax, esophageal injuries and thoracic trauma cases admitted to the emergency
MA
department.[2,3,4] Even if isolated rib fractures or fractures may not be early mortal, it may be mortal lately because of secondary pneumonia due to pain.[5] Treatment
PT ED
methods for pain are mainly NSAİD, opioid analgesics, thoracic epidural analgesia and paravertebral block (PVB). PVB is an effective method in rib fractures but PVB is providing only ipsilateral segmental thoracic analgesia.[6] Finally, we think that retrolaminar block is very usefull technique for pain relief with
CE
safety for other tecniques. But paravertebral block is effective at the block side and segmental. For this reason it isn’t very practical at multi-location pain like multiple
AC
rib fractures.
[1] Yoshida H, et al, A modified paravertebral block to reduce risk of mortality in a patientwith
multiple
rib
fractures,
Am
J
Emerg
Med
(2014),
http://dx.doi.org/10.1016/j.ajem.2014.10.032 [2] Chen CL, Cheng YL. Delayed massive hemothorax complicating simple rib fracture associated with diaphragmatic injury. Am J Emerg Med. 2014 Jul;32(7):818.e3-4. doi: 10.1016/j.ajem.2013.12.060. Epub 2014 Jan 7.
ACCEPTED MANUSCRIPT [3] Sekizawa A1, Yanagawa Y, Nishi K, Takasu A, Sakamoto T. A case of thoracic degloving injury with flail chest. Am J Emerg Med. 2011 Sep;29(7):841.e1-2. doi:
RI PT
10.1016/j.ajem.2010.06.021. Epub 2010 Oct 8. [4] Kouritas VK1, Matheos E, Baloyiannis I, Spyridakis M, Desimonas N, Hatzitheofilou
SC
K. Late presentation of jejunal perforation after thoracic trauma. Am J Emerg Med.
NU
2009 Nov;27(9):1177.e1-3. doi: 10.1016/j.ajem.2009.02.018. [5] Battle CE, Hutchings H, Evans PA. Risk factors that predict mortality in patients
MA
with blunt chest wall trauma: a systematic review and meta-analysis. Injury 2012 Jan;43(1):8-17.
AC
CE
Aug;81(2):230-8
PT ED
[6] Richardson J, Lönnqvist PA. Thoracic paravertebral block. Br J Anesth 1998
