RIB PAIN (Rib Fractures Treated With Parental Analgesia With Infused LidocaiNe)
Status:
Recruiting
Trial end date:
2022-06-01
Target enrollment:
Participant gender:
Summary
Traumatic rib fractures (RF) are a relatively common occurrence in patients of all ages, with
a 10% incidence in all trauma patients and are associated with significant morbidity and
mortality. Adequate analgesia is paramount for preventing pulmonary complications and can
reduce morbidity and mortality. There is longstanding evidence of lidocaine's effectiveness
and safety in the post-operative patient and the investigators hypothesize that this modality
may prove to be ideal in trauma patients with RF. Therefore, it is imperative that
intravenous lidocaine be investigated to ascertain if there is significant benefit for pain
reduction in patients who have sustained rib fractures.
A single-centre, double-blind, randomized control trial to evaluate the analgesic efficacy of
a 72-96 hour IV lidocaine infusion plus standard analgesics versus placebo infusion plus
standard analgesics will be performed on patients (age 18 or older) diagnosed with two or
more traumatic rib fractures ,from blunt thoracic trauma, requiring hospital admission at
Victoria Hospital.
The primary outcome is mean pain score, as measured on the Visual Analog Scale (VAS) when the
patient is at rest and with movement. Secondary outcomes are protocol adherence, patient
satisfaction as measured on the VAS, incidence of respiratory failure requiring mechanical
ventilation, hospital length of stay, ICU length of stay, mortality, incidence of lidocaine
toxicity, treatment regimens (use of additional non-opioid analgesics) and total morphine
equivalents used (including breakthrough doses).
This trial will serve to quantify the analgesic efficacy of intravenous lidocaine for
patients with traumatic rib fractures. Successful completion of a single centre trial will
inform the development of a multi-centre trial powered to demonstrate a reduction in
respiratory failure in the trauma population.