Title – The Impact of Patient and Provider Variables on Peak Serum Lidocaine Levels Following Catheter Placement for Rib Fracture Pain

Authors – Patrick Halliday MD¹, Daniel Gessner MD¹

1. Department of Anesthesiology, Perioperative and Pain Medicine, Division of Regional Anesthesiology, Stanford University Medical Center

Introduction – Traditional methods of managing pain for rib fractures entail the use of opioid and non-opioid analgesics. At our institution, pain management for patients presenting with multiple rib fractures often involves placement of peripheral nerve catheters. Lidocaine is frequently infused through these catheters for its efficacy and monitoring of serum levels. Numerous patient factors such as liver and renal function, body mass index, and comorbid illness can lead to variability in plasma lidocaine concentrations. Lesser known is to what degree patient-independent variables such as block type, catheter type, or provider training or experience influence peak lidocaine levels in this population. Our retrospective analysis aims to address some of these questions, in addition to examining more traditional patient-dependent variables.