EVALUATING THE EFFECTIVENESS OF EPIDURAL VERSUS INTRAVENOUS TRAMADOL FOR PAIN MANAGEMENT IN MULTIPLE RIB FRACTURES
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Keywords
Rib fractures, pain management, epidural analgesia, intravenous opioids, Visual Analogue Scale (VAS), thoracic trauma, analgesia comparison
Abstract
Background: Pain management in patients with multiple rib fractures is a critical aspect of care, as inadequate pain control can lead to serious complications such as pneumonia, atelectasis, and prolonged hospital stays. This study compares the efficacy of epidural analgesia versus intravenous opioids in managing pain among patients with multiple rib fractures.
Methods: A prospective interventional study was conducted at the Department of General Surgery, SSIMS&RC, Davangere, from March 2022 to October 2023. A total of 36 patients with more than three rib fractures were randomly assigned to two groups: Group A (epidural analgesia) and Group B (intravenous opioids). Pain levels were assessed using the Visual Analogue Scale (VAS) on Days 0, 3, and 7. Data were analysed using independent sample t-tests, with a p-value of <0.05 considered statistically significant.
Results: On Day 0, the mean VAS scores were comparable between Group A (9.28 ± 0.669) and Group B (9.61 ± 0.608), with no significant difference (p = 0.127). By Day 3, pain scores decreased in both groups, but Group A showed a trend towards lower pain levels (6.25 ± 1.571) compared to Group B (7.19 ± 1.167), though this difference was not statistically significant (p = 0.065). By Day 7, Group A experienced significantly lower pain levels (2.81 ± 1.167) compared to Group B (5.19 ± 1.109), with a statistically significant difference (p < 0.001).
Conclusion: Epidural analgesia provides superior pain control compared to intravenous opioids, particularly in the later stages of recovery, for patients with multiple rib fractures. These findings suggest that epidural analgesia should be considered as a first-line treatment for pain management in this patient population, potentially leading to faster recovery and reduced hospital stays.
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Dr Linganagouda S Patil
Professor and HOD in the Department of General Surgery,
Dr Yashaswini P M
Third year and First year post graduates in the Department of General Surgery, SS institute of Medical Sciences And Research Centre, Davanagere, Karnataka, India,
Dr Sujay D J
Consultant Physician in the Department of General Medicine, BSR Health Care, BM road, Kushalnagar, Somwarpet Taluk, Kodagu, Karnataka, INDIA.
Dr P Shiva Sai Reddy
Third year and First year post graduates in the Department of General Surgery, SS institute of Medical Sciences And Research Centre, Davanagere, Karnataka, India,