Article Text

Download PDFPDF
The Treatment of Patients with Multiple Rib Fractures Using Continuous Thoracic Epidural Narcotic Infusion
  1. David A. Ullman, MD,
  2. Rollin E. Wimpy, MD,
  3. John B. Fortune, MD,
  4. Thomas M. Kennedy, MD and
  5. Barry B. Greenhouse, MD
  1. From the Department of Anesthesiology, Albany Medical Center, Albany, New York


The incidence of tracheostomy, length of intensive care unit (ICU) and total hospital stay, and duration of ventilatory support were evaluated prospectively in 28 patients who had multiple rib fractures. The patients were randomly divided into two groups: 13 patients were given standard morphine parenteral analgesia and constituted the control group (Group 1), and 15 patients had thoracic epidural catheter placement within 72 hours from the time of admission to the ICU (Group 2). Group 2 patients had less ventilator-dependent time compared with control patients (3.07±1.35 days vs. 18.23±8.12 days, p <0.05), less time in ICU (5.93±1.44 days vs. 18.69±5.25 days, p <0.02), and a shorter hospital stay (14.85±2.21 days vs. 47.69±14.67 days, p <0.03). Group 2 patients also had a lower incidence of tracheostomy versus control patients (6.7±6.7% vs. 38.5±14.0%, p <0.05). The authors believe that continuous thoracic epidural morphine analgesia may provide distinct pulmonary and economic advantages in patients with multiple rib fractures.

  • Epidural morphine analgesia
  • multiple rib fractures
  • thoracic injury
  • thoracic epidural catheter

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.