Pain Relief for Ventilated Patients With Multiple Rib Fractures Using the ON-Q Pain Relief System

The purpose of this study is to find out if patients having the ON-Q post-op Pain Relief
System for pain management of multiple rib fractures will require fewer ventilator days, and
will need less IV pain medicine to control their pain, and as a result have improved
respiratory function during their recovery.

The standard of care for providing pain relief for rib fractures is to use an opioid drug
that is injected into the vein but also has side effects. Increased doses can lead to over
sedation and consequently lead to difficulty with breathing. The ON-Q pain relief systems
uses a local anesthetic under the skin. The anesthetic is called bupivicaine, and it is
delivered from a thin tube approximately 10 inches long is tunneled under the skin along the
back and parallel to the spine. The medication is stored in an elastic pump which delivers
a slow continuous drip of medication from multiple holes in the tubing. Subjects will be
randomized to either standard intravenous opioid pain management or the ON-Q pain relief
device with supplemental opioid medication if needed. The device will remain in use until
the subjects are able to breathe without the ventilator.