Thoracic para-vertebral infusion of bupivacaine for multiple unilateral rib fractures .
Prospective, Randomized Comparison of Continuous Thoracic Epidural and Thoracic Paravertebral Infusion in Patients With Unilateral Multiple Fractured Ribs-A Pilot Study
J Trauma. 2009 Apr;66(4):1096-10130 adults with 3 or more unilateral rib fractures were randomized to receive either continuous analgesia via thoracic epidural infusion (TEA) or thoracic para-vertebral infusion of bupivacaine (TPVB). This study assessed the efficacy of TPVB and compared it to the standard treatment of TEA. The results of this trial indicated no differences in pain relief or respiratory rate following infusion. There were also no differences in additional requirements of morphine or hospital stay time. It should be noted that the TEA group had a significantly greater number of occurrences of hypotension during the treatment.
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