Serratus Anterior Plane Blocks for Early Rib Fracture Pain Management: The SABRE Randomized Clinical Trial
Authors' conclusion
This randomized clinical trial found that the addition of an SAPB to standard rib fracture care significantly increased the proportion of patients who experienced a meaningful reduction in their pain score while also reducing in-hospital opioid requirements.
Study context
- Population
- Patients aged ≥16 years with clinically suspected or radiologically proven rib fractures in 8 EDs, New South Wales, Australia; excluded if intubated, transferred for urgent surgery or major concomitant nonthoracic injury588 screened
- Participants
- 210 patients
- Comparison
- Serratus anterior plane block (SAPB) plus standard care vs standard care alone
- SAPBn = 105
- Standard caren = 105reference
- Primary endpoint
- Composite pain score:
- Pain score reduction ≥2 points
- Absolute pain score <4 out of 10
- Follow-up
- 4 hours after enrollment
Methodological detailsmulticentre, open-label, pragmatic, Conducted April 12, 2021 to January 22, 2022; data analysed September 2022 to July 2023
- Multicentre
- Open-label
- Pragmatic
- Conducted April 12, 2021 to January 22, 2022; data analysed September 2022 to July 2023
Primary result
As reported in the abstract
Relative risk
0.73
95% CI 0.60–0.89
P = 0.001
Events by treatment group
SAPB vs Standard care
RR 0.73 (95% CI 0.60–0.89); P = 0.001
Further findings
Total opioid requirement · 24 hours
Hospital LOS
30-day mortality
Total opioid requirement · 24 hours
- Clinically significant reduction in overall opioid consumption with SAPB
Hospital LOS
- Similar between groups
30-day mortality
- Similar between groups
Safety
Pneumonia
Pneumonia
- Similar between groups
Original publication
Serratus Anterior Plane Blocks for Early Rib Fracture Pain Management: The SABRE Randomized Clinical Trial. JAMA Surg. Published 1 July 2024. doi:10.
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