Erdem Ahmet Burak, Donmez Safa, Sener Alp
Department of Emergency Medicine, Ministry of Health Ankara City Hospital, Emergency Medicine, Ankara, Turkiye.
Department of Emergency Medicine, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkiye.
J Coll Physicians Surg Pak. 2023 May;33(5):491-497. doi: 10.29271/jcpsp.2023.05.491.
To compare the analgesic efficacy of lidocaine spray with tramadol hydrochloride and fentanyl citrate in rib fractures.
A randomised, controlled open-label study. Place and Duration of the Study: Ministry of Health Ankara City Hospital, Turkiye, from June to November 2021.
Patients over the age of 18 years, who applied to the Emergency Department with blunt chest trauma, were divided into three groups. Groups were created from patients who were given lidocaine 10% spray (local), i.v. 100 mg of tramadol, and i.v. fentanyl 50 mcg. A total of 48 patients, each of whom was 16, were included in the study. Numerical rating scale (NRS) pain scores of the patients at baseline, 15th, 30th and 60th minutes were compared. These scores and the number of falls at follow-up were analysed comparatively between the 3 groups.
The age and gender distribution of the patients included in the study were found to be statistically similar between the groups. Although the degrees of decrease in NRS scores in the 0-15, 0-30, and 0-60 minute periods were higher in the tramadol group, these differences were not statistically significant (p=0.465/ 0.256/ 0.678, respectively). While no side effects were observed in the lidocaine group, there were 4 (25.0%) patients in the fentanyl group and 2 (12.5%) patients in the tramadol group.
Lidocaine spray can be used safely in the management of acute pain in rib fractures, as it has fewer side effects and is as effective as opiates.
Analgesia, Fentanyl, Lidocaine spray, Pain, Rib fracture, Tramadol.
比较利多卡因喷雾剂与盐酸曲马多和枸橼酸芬太尼在肋骨骨折中的镇痛效果。
一项随机、对照、开放标签研究。研究地点和时间：土耳其安卡拉市卫生部医院，2021年6月至11月。
18岁以上因钝性胸部创伤就诊于急诊科的患者分为三组。分组来自接受10%利多卡因喷雾剂（局部）、静脉注射100mg曲马多和静脉注射50μg芬太尼的患者。共有48名患者，每组16名，纳入本研究。比较患者在基线、第15、30和60分钟时的数字评分量表（NRS）疼痛评分。对这3组患者的这些评分以及随访时的跌倒次数进行了比较分析。
研究纳入患者的年龄和性别分布在各组之间具有统计学相似性。虽然曲马多组在0 - 15分钟、0 - 30分钟和0 - 60分钟期间NRS评分的下降程度较高，但这些差异无统计学意义（分别为p = 0.465 / 0.256 / 0.678）。利多卡因组未观察到副作用，芬太尼组有4名（25.0%）患者，曲马多组有2名（12.5%）患者出现副作用。
利多卡因喷雾剂可安全用于肋骨骨折急性疼痛的管理，因为它副作用较少且与阿片类药物效果相当。
镇痛；芬太尼；利多卡因喷雾剂；疼痛；肋骨骨折；曲马多
