• Ahmet Burak Erdem, Safa Donmez, and Alp Sener.
• Department of Emergency Medicine, Ministry of Health Ankara City Hospital, Emergency Medicine, Ankara, Turkiye.
• J Coll Physicians Surg Pak. 2023 May 1; 33 (5): 491497491-497.

ObjectiveTo compare the analgesic efficacy of lidocaine spray with tramadol hydrochloride and fentanyl citrate in rib fractures.Study DesignA randomised, controlled open-label study. Place and Duration of the Study: Ministry of Health Ankara City Hospital, Turkiye, from June to November 2021.MethodologyPatients 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.ResultsThe 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.ConclusionLidocaine 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.Key WordsAnalgesia, Fentanyl, Lidocaine spray, Pain, Rib fracture, Tramadol.

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