UltrasouNd-guided Percutaneous Intercostal Nerve Cryoneurolysis for Analgesia Following Traumatic Rib Fracture

Launched by SUNNYBROOK HEALTH SCIENCES CENTRE · May 9, 2023

Keywords

ClinConnect Summary

This clinical trial is looking at a new way to help manage pain for patients with traumatic rib fractures, which are painful injuries often caused by accidents. The study tests a technique called cryoneurolysis, where a small tool is used to freeze the nerves responsible for pain. The goal is to see if this method can provide better pain relief than traditional pain management alone. If the initial tests are successful, the researchers plan to expand the study to include more participants to get a clearer understanding of its effectiveness.

To participate in this trial, individuals need to be at least 18 years old and have a certain number of broken ribs (between 3 to 8) from a recent injury. They also need to be within 48 hours of being admitted to the hospital. Participants will be asked to keep track of their pain levels and any medications they take for three months after the procedure. This study is currently recruiting participants and aims to find a better way to help those suffering from rib fracture pain improve their quality of life.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Aged ≥18
• • Unilateral traumatic rib fractures (3 to 8)
• • Candidate for ESP block catheter
• • Within 48hrs of admission to hospital
• Exclusion Criteria:
• • Lack of patient consent; unlikely to comply with follow up
• • Unable to use Patient Controlled Regional Analgesia (Ventilated/sedated patients or Moderate to severe traumatic brain injury)
• • Chronic pain (opioid use \> 30mg oral morphine equivalent per day)
• • Substance use disorder
• • CrCl \< 50
• • BMI \> 45
• • Significant distracting injuries (unreduced long bone fractures, unstable pelvic or spine fractures and patients requiring trauma laparotomy- also preclude positioning for block placement (lateral decubitus or sitting up))
• • Contraindications for ESP catheter placement (pre-existing medical/neurological/hematologic diseases, localized infection/trauma at site of intervention, allergy to amide local anesthetics)
• • Contraindications to CN (cryoglobulinemia, paroxysmal cold hemoglobinuria, multiple myeloma and cold urticarial).
• • Unable to return to Trauma Recovery Clinic (in-person or virtual) at 3 months