Pain management of acute limb trauma patients with intravenous lidocaine in emergency department

This study was designed to assess the possible superiority of intravenous lidocaine to morphine for pain management. This was a randomized double blind controlled superiority trial, carried on in the emergency department (ED). Traumatic patients older than 18-year-old with the complaint of acute pai...

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Bibliographic Details
Published in:The American journal of emergency medicine 2018-07, Vol.36 (7), p.1231-1235
Main Authors: Farahmand, Shervin, Hamrah, Hadid, Arbab, Mona, Sedaghat, Mojtaba, Basir Ghafouri, Hamed, Bagheri-Hariri, Shahram
Format: Article
Language:English
Subjects:
Acute pain
Analgesics
Blood pressure
Clinical trials
Demographics
Drug dosages
Emergency management
Emergency medical care
Emergency medical services
Emergency service, hospital
Extremities
Hypotheses
Intervention
Intravenous administration
Lidocaine
Morphine
Narcotics
Pain
Pain management
Statistical analysis
Trauma
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Summary:This study was designed to assess the possible superiority of intravenous lidocaine to morphine for pain management. This was a randomized double blind controlled superiority trial, carried on in the emergency department (ED). Traumatic patients older than 18-year-old with the complaint of acute pain greater than 4 on a numeric rating scale (NRS) from 0 to 10 on their extremities were eligible. One group received IV lidocaine (1.5 mg/kg), and the other received IV morphine (0.1mg/kg). Pain scores and adverse effects were assessed at 15, 30, 45 and 60 minutes and patients' satisfaction was evaluated two hours later. A minimum pain score reduction of 1.3 from baseline was considered clinically significant. Fifty patients with the mean age of 31.28±8.7 were enrolled (78% male). The demographic characteristics and pain scores of the two groups was similar. The on-arrival mean pain scores in two groups were, lidocaine: 7.9±1.4 and morphine: 8.0±1.4 (p=0.57) and after 1 hour were, lidocaine: 2.28±1.2 and morphine: 3.2±1.7. Although the pain score decreased significantly in both group (p=0.027), there were not any clinically and statistically significant difference between the two groups (p=0.77). Patients' satisfaction with pain management in both groups were almost similar (p=0.49). The reduction in pain score using IV lidocaine is not superior to IV morphine in adult ED patients with traumatic limb pain.
ISSN:0735-6757
1532-8171
DOI:10.1016/j.ajem.2017.12.027