J Trauma
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Randomized Controlled Trial Comparative Study Clinical Trial
Prospective evaluation of epidural versus intrapleural catheters for analgesia in chest wall trauma.
Severe blunt chest trauma can produce multiple rib fractures, flail segments, and pulmonary contusions. All of these injuries produce pain and diminished pulmonary function. The effectiveness of intrapleural and epidural administration of bupivacaine was prospectively evaluated in 19 patients with severe chest trauma. ⋯ Vital capacity, FIO2, minute ventilation, and respiratory rate were not affected. Mild hypotension was a common complication with epidural catheters. We conclude that continuous epidural analgesia is superior to intrapleural block and significantly improves tidal volume and negative inspiratory pressure.