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学术急诊医学档案

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  3. 卷 5 编号 1 (2017): Continuous volume
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卷 5 编号 1 (2017)

一月 2017

Intravenous Lidocaine versus Morphine Sulfate in Pain Management for Extremity Fractures; a Clinical Trial

  • Arash Forouzan
  • Hassan Barzegari
  • Hassan Motamed
  • Ali Khavanin
  • Hamideh Shiri

学术急诊医学档案, 卷 5 编号 1 (2017), 1 一月 2017 , 第 e68 页
https://doi.org/10.22037/aaem.v5i1.193 已出版: 2017-05-28

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摘要

Introduction: 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. Method: 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. Results: 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). Conclusion: Based on the results of the present study, IV lidocaine could be considered as a reasonable alternative choice for pain management in ED.
关键词:
  • Lidocaine
  • morphine
  • pain management
  • emergency service
  • hospital
  • fractures
  • bone
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Forouzan A, Barzegari H, Motamed H, Khavanin A, Shiri H. Intravenous Lidocaine versus Morphine Sulfate in Pain Management for Extremity Fractures; a Clinical Trial. Arch Acad Emerg Med [网际网络]. 2017年5月28日 [见引于 2026年7月7日];5(1):e68. 载于: https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/193
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参考

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Koppert W, Weigand M, Neumann F, Sittl R, Schuettler J, Schmelz M, et al. Perioperative intravenous lidocaine has preventive effects on postoperative pain and morphine consumption after major abdominal surgery. Anesthesia & Analgesia. 2004;98(4):1050-5.

McCarthy GC, Megalla SA, Habib AS. Impact of intravenous lidocaine infusion on postoperative analgesia and recovery from surgery. Drugs. 2010;70(9):1149-63.

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Choi SJ, Kim MH, Jeong HY, Lee JJ. Effect of intraoperative lidocaine on anesthetic consumption, and bowel function, pain intensity, analgesic consumption and hospital stay after breast surgery. Korean journal of anesthesiology. 2012;62(5):429-34.

Grady P, Clark N, Lenahan J, Oudekerk C, Hawkins R, Nezat G, et al. Effect of intraoperative intravenous lidocaine on postoperative pain and return of bowel function after laparoscopic abdominal gynecologic procedures. AANA journal. 2012;80(4).

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Kaba A, Laurent SR, Detroz BJ, Sessler DI, Durieux ME, Lamy ML, et al. Intravenous lidocaine infusion facilitates acute rehabilitation after laparoscopic colectomy. The Journal of the American Society of Anesthesiologists. 2007;106(1):11-8.

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Martin F, Cherif K, Gentili ME, Enel D, Abe E, Alvarez JC, et al. Lack of impact of intravenous lidocaine on analgesia, functional recovery, and nociceptive pain threshold after total hip arthroplasty. The Journal of the American Society of Anesthesiologists. 2008;109(1):118-23.

Wasiak J, Mahar P, McGuinness SK, Spinks A, Danilla S, Cleland H. Intravenous lidocaine for the treatment of background or procedural burn pain. The Cochrane Library. 2012.

Farag E, Ghobrial M, Sessler DI, Dalton JE, Liu J, Lee JH, et al. Effect of perioperative intravenous lidocaine administration on pain, opioid consumption, and quality of life after complex spine surgery. The Journal of the American Society of Anesthesiologists. 2013;119(4):932-40.

Beaudoin FL, Haran JP, Liebmann O. A Comparison of Ultrasoundâ€guided Threeâ€inâ€one Femoral Nerve Block Versus Parenteral Opioids Alone for Analgesia in Emergency Department Patients With Hip Fractures: A Randomized Controlled Trial. Academic Emergency Medicine. 2013;20(6):584-91.

Sahota O, Rowlands M, Bradley J, Van de Walt G, Bedforth N, Armstrong S, et al. Femoral nerve block Intervention in Neck of Femur fracture (FINOF): study protocol for a randomized controlled trial. Trials. 2014;15(1):189.

Insler SR, O'Connor M, Samonte AF, Bazaral MG. Lidocaine and the inhibition of postoperative pain in coronary artery bypass patients. Journal of cardiothoracic and vascular anesthesia. 1995;9(5):541-6.

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Yardeni IZ, Beilin B, Mayburd E, Levinson Y, Bessler H. The effect of perioperative intravenous lidocaine on postoperative pain and immune function. Anesthesia and analgesia. 2009;109(5):1464-9.

Koppert W, Weigand M, Neumann F, Sittl R, Schuettler J, Schmelz M, et al. Perioperative intravenous lidocaine has preventive effects on postoperative pain and morphine consumption after major abdominal surgery. Anesthesia and analgesia. 2004;98(4):1050-5, table of contents.

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