Comparison of the Analgesic Efficacy of Lidocaine Spray versus Tramadol and Fentanyl for Pain Control in Rib Fractures

Objective: To compare the analgesic efficacy of lidocaine spray with tramadol hydrochloride and fentanyl citrate in rib fractures.Study Design: A randomised, controlled open-label study. Methodology: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.Results: 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.Conclusion: 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.