The impact of intercostal nerve block on the necessity of a second chest x-ray in patients with penetrating trauma: A randomised controlled trial

Objectives: Patients presented with penetrating trauma are immediately given an initial x-ray scan followed by the desired treatment. Intercostal nerve block in chest trauma patients is effective in pain management. The aim of this study is to investigate the need of second chest x-ray in penetrating chest trauma patients, following intercostal nerve block and evaluation of pain and other clinical parameters. Method: In this a randomized controlled trail, 100 patients with thoracic trauma were examined from June 2019-December 2019. All patients who entered the study underwent an intercostal nerve block by 5 mg of lidocaine. The results from normal and abnormal chest x-ray groups were compared following the block, in terms of the VAS (Visual Analogue Scale) score and hemodynamic parameters. Result: Among the two groups, normal second x-ray vs delayed hemopneumothorax, systolic blood pressure, rate of respiration and heart rate were not significantly at the time of admission and the time following the nerve block. However, this difference was significant in terms of visual analog scale score among the two groups.We also report that the VAS difference of more than 2.5 points has the specify of 76.5 and a sensitivity of 92.8 for the diagnosis of normal/stable patients. Conclusions: Intercostal nerve block reduces pain in patients who are not presented with hemopneumothorax, whereas, patients otherwise are presented with the significant pain. Second x-ray in patients with reduced pain in response to the nerve block, might not be necessarily required. (C) 2020 The Author(s). Published by Elsevier Ltd on behalf of Surgical Associates Ltd.