Lidocaine Infusions for Rib Fractures
| Status: | Recruiting |
|---|---|
| Conditions: | Orthopedic |
| Therapuetic Areas: | Orthopedics / Podiatry |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 6/30/2018 |
| Start Date: | June 15, 2018 |
| End Date: | July 1, 2019 |
| Contact: | Michael Y Lin, MD |
| Email: | mikelin@stanford.edu |
| Phone: | 4158431186 |
Efficacy of Intravenous Lidocaine Infusion for Traumatic Rib Fracture Pain Control
Patients with traumatic rib fractures not receiving regional anesthesia through a epidural or
nerve block catheter will be recruited for the study. Once enrolled, they will be randomized
to receive either intravenous lidocaine or intravenous saline for control of pain related to
their rib fractures. In addition, they will receive other pain medications, such as
acetaminophen, gabapentin, and opioid pain medications. Our primary outcome is a decrease in
their opioid medication requirements.
nerve block catheter will be recruited for the study. Once enrolled, they will be randomized
to receive either intravenous lidocaine or intravenous saline for control of pain related to
their rib fractures. In addition, they will receive other pain medications, such as
acetaminophen, gabapentin, and opioid pain medications. Our primary outcome is a decrease in
their opioid medication requirements.
Inclusion Criteria:
Patients aged 18 or older with 2+ rib fractures or > 65 with 2+ rib fractures Enrollment
within 16 hours of admission Inability to receive epidural placement or other
catheter-based regional anesthesia (coagulopathy, anticoagulation, bacteremia or infection
over epidural site, patient refusal, vertebral fracture, spinal cord injury, inability to
cooperate with procedure, BMI > 40) Isolated rib fracture (no other major injury or
anticipation for invasive procedure)
Exclusion Criteria:
Inability to participate in traditional pain measures Severe alcohol withdrawal Chronic
pain requiring opiates prior to admission GCS < 13 or inability to report pain Medical
instability Positive pressure ventilation, either via non-invasive mask or endotracheal
tube Hemodynamic instability or shock Flail chest with clinical evidence of paradoxical rib
motion Contraindication to lidocaine History of or current bradycardia (HR < 50) or heart
block (Mobitz II or 3rd degree) New onset or uncontrolled seizures Allergy to amide-type
local anesthetic
Enrollment in other study that may affect the results of this study
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