Forouzan Arash, Barzegari Hassan, Motamed Hassan, Khavanin Ali, Shiri Hamideh
Emergency Medicine Department, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Emerg (Tehran). 2017;5(1):e68. Epub 2017 May 28.
Considering the existing contradictions regarding effectiveness of intravenous (IV) lidocaine, especially in emergency department (ED), the present study was designed to compare the analgesic effect of IV lidocaine and morphine sulfate in pain management for extremity bone fractures.
In this triple blind clinical trial, 15 to 65 year-old patients with extremity fractures and in need of pain management were randomly allocated to either IV lidocaine or morphine sulfate group and were compared regarding severity of pain 5, 10, 15, 20, 25, and 30 minutes after infusion via intention to treat analysis. The absolute risk reduction, number needed to treat and relative risk of IV lidocaine after 30 minutes were 0.40 (95%CI: 0.25 - 0.64), 7 (95%CI: 3.7 - 23.1), and 20.71 (95%CI: 10.91 - 30.51), respectively.
280 patients with the mean age of 32.50 ± 12.77 years were randomly divided into 2 equal groups of 140 (73.9% male). The 2 groups had similar baseline characteristics. 15 minutes after injection success rate was 49.28% in lidocaine and 33.57% in morphine sulfate group (p = 0.011), and after 30 minutes it reached 85.71% and 65.00%, respectively (p < 0.001).
Based on the results of the present study, IV lidocaine could be considered as a reasonable alternative choice for pain management in ED.
鉴于静脉注射利多卡因有效性方面存在的矛盾，尤其是在急诊科，本研究旨在比较静脉注射利多卡因和硫酸吗啡在四肢骨折疼痛管理中的镇痛效果。
在这项三盲临床试验中，将15至65岁需要疼痛管理的四肢骨折患者随机分配到静脉注射利多卡因组或硫酸吗啡组，并通过意向性分析比较输注后5、10、15、20、25和30分钟时的疼痛严重程度。30分钟后静脉注射利多卡因的绝对风险降低率、需治疗人数和相对风险分别为0.40（95%可信区间：0.25 - 0.64）、7（95%可信区间：3.7 - 23.1）和20.71（95%可信区间：10.91 - 30.51）。
280例平均年龄为32.50±12.77岁的患者被随机分为两组，每组140例（男性占73.9%）。两组基线特征相似。注射后15分钟，利多卡因组成功率为49.28%，硫酸吗啡组为33.57%（p = 0.011），30分钟后分别达到85.71%和65.00%（p < 0.001）。
基于本研究结果，静脉注射利多卡因可被视为急诊科疼痛管理的合理替代选择。
