Examining Canadian Trauma Centres' Analgesic Protocols for Rib Fractures

Area of Science:

• Trauma Surgery
• Pain Management
• Anesthesiology

Background:

• Rib fractures are a common injury in blunt thoracic trauma, leading to significant pain and potential pulmonary complications.
• Current pain management strategies for rib fractures are suboptimal, highlighting the need for improved analgesia protocols.
• Intravenous lidocaine infusions show promise for pain management due to their safety profile and efficacy in other conditions.

Purpose of the Study:

• To assess current practices and familiarity with intravenous lidocaine infusions for rib fracture pain management in Canadian trauma centers.
• To identify common analgesic protocols for rib fractures across Canadian trauma centers.
• To gauge interest in participating in future multi-center trials investigating lidocaine for traumatic rib fractures.

Main Methods:

• An online survey was distributed to 14 Canadian trauma centers.
• Survey questions addressed trauma center characteristics, pain management strategies, and current/potential use of IV lidocaine.
• Data analysis included frequency and thematic analysis of survey responses.

Main Results:

• 12 trauma centers responded, with 50% reporting >450 annual trauma admissions (ISS > 12).
• 50% of responding centers have established rib fracture analgesic protocols.
• 33% of centers frequently use IV lidocaine for rib fractures, and 83% support further research in this area.

Conclusions:

• Current practices for managing rib fracture pain in Canadian trauma centers are inconsistent.
• Further prospective research is required to evaluate the efficacy of intravenous lidocaine as an analgesic for traumatic rib fractures.