Katou Ryota, Mano Tomoo, Masuda Takashi
Department of Rehabilitation Medicine, Nara Prefecture General Medical Center, Japan.
Department of Neurology, Nara Medical University: 840 Shijo-cho, Kashihara, Nara 634-8521, Japan.
J Phys Ther Sci. 2023 Sep;35(9):673-677. doi: 10.1589/jpts.35.673. Epub 2023 Sep 2.
[Purpose] Respiratory physiotherapy plays an important role in the management of acute respiratory disturbance; however, chest pain often impedes patients from performing respiratory physiotherapy. In this study, we investigated whether pain due to multiple rib fractures can be managed with intermittent serratus anterior fascia plane (SAP) block. [Participants and Methods] We performed intermittent SAP blocks in three consecutive patients with pain due to multiple rib fractures based on the level of pain. The level of pain and differences in expiratory/inspiratory chest expansion were evaluated before and after performing the SAP block. [Results] All three patients reported an improvement in the severity of pain and increase in the thoracic range of motion after receiving the SAP block. No adverse events associated with intermittent SAP blocks were observed in any of the patients. [Conclusion] We report the cases of three patients who completed respiratory physiotherapy after receiving intermittent SAP blocks for the management of pain due to multiple rib fractures. SAP blocks are associated with a low risk of complications as the ribs are not punctured while performing SAP blocks.
[目的] 呼吸物理治疗在急性呼吸功能障碍的管理中起着重要作用；然而，胸痛常常妨碍患者进行呼吸物理治疗。在本研究中，我们调查了多发肋骨骨折所致疼痛是否可通过间歇性前锯肌筋膜平面（SAP）阻滞来处理。[参与者与方法] 我们根据疼痛程度，对3例因多发肋骨骨折而疼痛的连续患者进行了间歇性SAP阻滞。在进行SAP阻滞前后，评估疼痛程度以及呼气/吸气时胸廓扩张度的差异。[结果] 所有3例患者在接受SAP阻滞后均报告疼痛严重程度有所改善，胸廓活动范围增加。所有患者均未观察到与间歇性SAP阻滞相关的不良事件。[结论] 我们报告了3例患者在接受间歇性SAP阻滞以处理多发肋骨骨折所致疼痛后完成呼吸物理治疗的病例。由于在进行SAP阻滞时未穿刺肋骨，SAP阻滞相关并发症风险较低。
