• Shervin Farahmand, Hadid Hamrah, Mona Arbab, Mojtaba Sedaghat, Basir Ghafouri Hamed H Trauma and Injury Research Center, Iran University of Medical Sciences, Tehran, Iran., and Shahram Bagheri-Hariri.
• Emergency Medicine Department, Tehran University of Medical Sciences, Tehran, Iran.
• Am J Emerg Med. 2018 Jul 1; 36 (7): 1231-1235.

IntroductionThis study was designed to assess the possible superiority of intravenous lidocaine to morphine for pain management.MethodsThis 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.ResultsFifty 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).ConclusionThe reduction in pain score using IV lidocaine is not superior to IV morphine in adult ED patients with traumatic limb pain.Copyright © 2017 Elsevier Inc. All rights reserved.

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