Cryoanalgesia for Rib fracture Pain (CRP)
Research type
Research Study
Full title
Intercostal nerve cryoablation for management of pain from rib fractures.
IRAS ID
296372
Contact name
Alison Knaggs
Contact email
Sponsor organisation
Imperial College London and Imperial College Healthcare NHS Trust
Duration of Study in the UK
1 years, 0 months, 0 days
Research summary
As a Major Trauma Centre, many patients admitted to St Mary's Hospital have fractured ribs following an accident. In 2019 over 400 such people were admitted. Over a quarter of those admitted with rib fractures cannot cope with just simple pain killers. They need a more invasive treatment. This usually takes the form of an epidural, a tube in the back to give pain mediation directly to nerves near the spine. Without this they may develop pneumonia as the person cannot take deep breaths and cough. Epidurals can have severe side effects, especially the ones used for rib fractures, and can only stay in for a few days. Patients cannot be discharged while they have an epidural in situ so often stay in hospital for approximately a fortnight. In order to cope with the pain once the epidural has been removed, the patient often needs strong opioids (morphine-like drugs) which have unpleasant side affects and can result in addiction.
This study intends to explore the role that cryoanalgesia may play in treating this pain. Cryoanalgesia has been in use since 1974. It is a small probe that when placed alongside a nerve can freeze it so that it no longer transmits signals. The nerve will return to normal after a few weeks. In the last ten years the technology for using cryoanalgesia in pain management has improved, so it is being use more often to treat acute pain. It has already been successfully used to treat pain from rib fractures. Cryoanalgesia has no long term side effects. For the cryoanalgesia procedure the patient will not be subjected to any extra inconvenience compared to what currently happens during an epidural insertion. It is a once-off procedure and will hopefully mean that the patient needs less opioids and can be discharged earlier.
REC name
North West - Greater Manchester Central Research Ethics Committee
REC reference
21/NW/0149
Date of REC Opinion
12 Jul 2021
REC opinion
Further Information Favourable Opinion