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

Shervin Farahmand, Hadid Hamrah, Mona Arbab, Mojtaba Sedaghat, Hamed Basir Ghafouri, Shahram Bagheri-Hariri

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

Introduction: This study was designed to assess the possible superiority of intravenous lidocaine to morphine for pain management. Methods: 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 (0.1 mg/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. Results: 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). Conclusion: The reduction in pain score using IV lidocaine is not superior to IV morphine in adult ED patients with traumatic limb pain.

Original languageEnglish (US)
Pages (from-to)1231-1235
Number of pages5
JournalAmerican Journal of Emergency Medicine
Volume36
Issue number7
DOIs
StatePublished - Jul 2018
Externally publishedYes

Keywords

  • Acute pain
  • Emergency service, hospital
  • Lidocaine
  • Morphine
  • Pain management

ASJC Scopus subject areas

  • Emergency Medicine

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