Other Titles
Epidural Analgesia Compared to Other Pain Management Options in Traumatic Rib Fractured Patients: An Integrative Research Review [Poster Title]
Abstract
Traumatic rib fractures are a diagnosis associated with high morbidity and mortality rates (Duch & Moller, 2015). When pain is ineffectively managed, patients can experience limitations in their ability to cough and mobilize putting them at risk for significant atelectasis, retention of pulmonary secretions, and pneumonia (Diwan et al., 2022). Thoracic epidural analgesia is the gold-standard for pain control in this population but other modalities for pain control such as enteral, IV, and regional ultrasound guided techniques exist. Medline Complete, CINAHL Plus with Full Text, Health Research Premium Collection, PubMed and Cochrane were searched for peer reviewed articles. Search terms used were “epidural analgesia” and “traumatic rib fractures” and “systematic review or meta-analysis.” The search criteria were limited to articles published between the years 2017-2024 in Medline Complete and Health Research Premium Collection, 2009-2024 in CINAHL Plus with Full Text and PubMed, and no date limitations in Cochrane. A total of 122 articles were found with 6 duplicates. Only 12 articles could be included for the Integrative Research Review. Exclusion criteria consisted of articles not encompassing the study question, population, abstracts, and trials without results. Furthermore, 4 articles were found via bibliographic mining to be included into the 12 final article for review made of six level 1 systematic reviews, four level IV studies, and two level III studies. All articles were appraised using the Prisma checklist, the Mixed-Methods Appraisal Tool, or the AGREE II tool. The articles were graded using the EBR tool, step seven (Long & Gannaway, 2015) with the GRADE working group. While thoracic epidural analgesia is still the preferred analgesic modality for most patients with multiple traumatic rib fractures, there are less complex and comparable options available to patients with fewer contraindications (Diwan et al., 2022). A multimodal and multidisciplinary approach to traumatic rib fractures is the recommended technique for managing analgesia and reducing morbidity and mortality associated with rib fractured patients (Hammal et al., 2024). Further studies with larger sample sizes, higher quality of evidence, and lower risk for bias are necessary to confirm the optimization of pain with epidural analgesia compared with other analgesic intervention in patients with traumatic rib fractures (Duch & Moller, 2015).
Sigma Membership
Non-member
Type
Poster
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Acute Care, Interprofessional, Interdisciplinary, Rib Fractures, Pain Management
Recommended Citation
Robles, Amelia Clarice, "Pain Management with Epidural Analgesia in Rib Fractured Patients: An IRR" (2025). International Nursing Research Congress (INRC). 123.
https://www.sigmarepository.org/inrc/2025/posters_2025/123
Conference Name
36th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Seattle, Washington, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Pain Management with Epidural Analgesia in Rib Fractured Patients: An IRR
Seattle, Washington, USA
Traumatic rib fractures are a diagnosis associated with high morbidity and mortality rates (Duch & Moller, 2015). When pain is ineffectively managed, patients can experience limitations in their ability to cough and mobilize putting them at risk for significant atelectasis, retention of pulmonary secretions, and pneumonia (Diwan et al., 2022). Thoracic epidural analgesia is the gold-standard for pain control in this population but other modalities for pain control such as enteral, IV, and regional ultrasound guided techniques exist. Medline Complete, CINAHL Plus with Full Text, Health Research Premium Collection, PubMed and Cochrane were searched for peer reviewed articles. Search terms used were “epidural analgesia” and “traumatic rib fractures” and “systematic review or meta-analysis.” The search criteria were limited to articles published between the years 2017-2024 in Medline Complete and Health Research Premium Collection, 2009-2024 in CINAHL Plus with Full Text and PubMed, and no date limitations in Cochrane. A total of 122 articles were found with 6 duplicates. Only 12 articles could be included for the Integrative Research Review. Exclusion criteria consisted of articles not encompassing the study question, population, abstracts, and trials without results. Furthermore, 4 articles were found via bibliographic mining to be included into the 12 final article for review made of six level 1 systematic reviews, four level IV studies, and two level III studies. All articles were appraised using the Prisma checklist, the Mixed-Methods Appraisal Tool, or the AGREE II tool. The articles were graded using the EBR tool, step seven (Long & Gannaway, 2015) with the GRADE working group. While thoracic epidural analgesia is still the preferred analgesic modality for most patients with multiple traumatic rib fractures, there are less complex and comparable options available to patients with fewer contraindications (Diwan et al., 2022). A multimodal and multidisciplinary approach to traumatic rib fractures is the recommended technique for managing analgesia and reducing morbidity and mortality associated with rib fractured patients (Hammal et al., 2024). Further studies with larger sample sizes, higher quality of evidence, and lower risk for bias are necessary to confirm the optimization of pain with epidural analgesia compared with other analgesic intervention in patients with traumatic rib fractures (Duch & Moller, 2015).
Description
This IRR answers the research question, “In traumatic rib fractured patients, does the use of epidural analgesia compared to other forms of pain control improve the overall management of pain?” Included are six level one systematic reviews, three with meta-analysis, four level fours studies involving retrospective cohorts, and two level three studies ranging from 1999 to present day data collection.