Background and aims Rib fracture is commonly associated with high morbidity and mortality. Poorly managed analgesia for rib fractures can lead to complications and prolonged hospital stay. Anaesthetists are commonly involved in management of pain, especially with epidural analgesia. The aim of our audit was to establish the association of epidural analgesia with trauma score and length of stay in hospital.
Methods From year 2017 to 2018, 150 patients admitted with rib fractures were identified randomly. Patient‘s notes were reviewed retrospectively and data collected include demographics, trauma score, status of epidural analgesia and length of hospital stay.
Results Among 150 patients, 23% (n=35) received epidural analgesia. Among patients with epidural, 8.6% had hospital stay of between 0 to 5 days, 45.7% between 5 to 10 days, 22.9% stayed between 11 to 15 days, 2.9% stayed between 16 to 20 days and 20% stayed 21 days and beyond. Among 77% (n=115) who did not receive epidural, 54.8% stayed between 0 to 5 days, 15.6% stayed between 5 to 10 days, 11.3% stayed between 11 to 15 days, 6.1% stayed between 16 to 20 days and 12.2% stayed beyond 20 days.
Conclusions Multi-modal analgesia approach for rib fracture was suggested by various guidelines such as UK NICE and AAGBI. That includes regular oral analgesia, local anaesthetic trans-dermal patch, various plane blocks and epidural analgesia. The result has not showed definite improvement in analgesia control with epidural analgesia. The efficacy of epidural analgesia will depend of appropriate patient selection and clinical correlation.
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