Cargando…

Intravenous Lidocaine Compared to Fentanyl in Renal Colic Pain Management; a Randomized Clinical Trial

INTRODUCTION: Using alpha blockers such as intravenous (IV) lidocaine has been deemed effective in controlling acute pain. Therefore, the current study was designed with the aim of evaluating the efficiency of IV lidocaine in comparison to IV fentanyl in pain management of patients with renal colic...

Descripción completa

Detalles Bibliográficos
Autores principales: Motamed, Hassan, Maleki Verki, Mohammadreza
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Shahid Beheshti University of Medical Sciences 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5703759/
https://www.ncbi.nlm.nih.gov/pubmed/29201964
http://dx.doi.org/10.22037/emergency.v5i1.18894
_version_ 1783281744539025408
author Motamed, Hassan
Maleki Verki, Mohammadreza
author_facet Motamed, Hassan
Maleki Verki, Mohammadreza
author_sort Motamed, Hassan
collection PubMed
description INTRODUCTION: Using alpha blockers such as intravenous (IV) lidocaine has been deemed effective in controlling acute pain. Therefore, the current study was designed with the aim of evaluating the efficiency of IV lidocaine in comparison to IV fentanyl in pain management of patients with renal colic in emergency department (ED). METHODS: In this double blind clinical trial, 18-65 year old patients that presented to ED with colicky flank pain and met the inclusion criteria of the study were allocated to either lidocaine or fentanyl group using block randomization and compared regarding pain severity 5, 10, 15, and 30 minutes after drug administration. RESULTS: 90 patients with the mean age of 35.75±8.87 years were divided into 2 groups of 45 (90% male). The 2 groups were not significantly different regarding the studied baseline variables. Pain severity was not significantly different between the 2 groups at various times after injection. Treatment failure rate 15 minutes after injection was 44.4% (20 cases) in IV lidocaine and 17.8% (8 cases) in IV fentanyl group (p = 0.006). These rates were 26.6% (12 patients) versus 22.2% 30 minutes after injection (p = 0.624). Absolute risk increase of treatment failure in case of using lidocaine was 26.7 (95% CI: 8.3-44.9) in the 15(th) minute and 4.4 (95% CI: 13.3-22.2) 30 minutes after injection. Number needed to harm (NNH) in treatment with lidocaine 15 and 30 minutes after injection were 4 (95% CI: 2.2-12.0) and 23, respectively. CONCLUSION: Although mean pain severity was not significantly different between IV fentanyl and lidocaine at various times after injection, treatment failure rate was significantly higher in the IV lidocaine group 15 minutes after injection.
format Online
Article
Text
id pubmed-5703759
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher Shahid Beheshti University of Medical Sciences
record_format MEDLINE/PubMed
spelling pubmed-57037592017-11-30 Intravenous Lidocaine Compared to Fentanyl in Renal Colic Pain Management; a Randomized Clinical Trial Motamed, Hassan Maleki Verki, Mohammadreza Emerg (Tehran) Original Research INTRODUCTION: Using alpha blockers such as intravenous (IV) lidocaine has been deemed effective in controlling acute pain. Therefore, the current study was designed with the aim of evaluating the efficiency of IV lidocaine in comparison to IV fentanyl in pain management of patients with renal colic in emergency department (ED). METHODS: In this double blind clinical trial, 18-65 year old patients that presented to ED with colicky flank pain and met the inclusion criteria of the study were allocated to either lidocaine or fentanyl group using block randomization and compared regarding pain severity 5, 10, 15, and 30 minutes after drug administration. RESULTS: 90 patients with the mean age of 35.75±8.87 years were divided into 2 groups of 45 (90% male). The 2 groups were not significantly different regarding the studied baseline variables. Pain severity was not significantly different between the 2 groups at various times after injection. Treatment failure rate 15 minutes after injection was 44.4% (20 cases) in IV lidocaine and 17.8% (8 cases) in IV fentanyl group (p = 0.006). These rates were 26.6% (12 patients) versus 22.2% 30 minutes after injection (p = 0.624). Absolute risk increase of treatment failure in case of using lidocaine was 26.7 (95% CI: 8.3-44.9) in the 15(th) minute and 4.4 (95% CI: 13.3-22.2) 30 minutes after injection. Number needed to harm (NNH) in treatment with lidocaine 15 and 30 minutes after injection were 4 (95% CI: 2.2-12.0) and 23, respectively. CONCLUSION: Although mean pain severity was not significantly different between IV fentanyl and lidocaine at various times after injection, treatment failure rate was significantly higher in the IV lidocaine group 15 minutes after injection. Shahid Beheshti University of Medical Sciences 2017 2017-10-23 /pmc/articles/PMC5703759/ /pubmed/29201964 http://dx.doi.org/10.22037/emergency.v5i1.18894 Text en © Copyright (2017) Shahid Beheshti University of Medical Sciences This is an Open Access article distributed under the terms of the Creative Commons Attribution License, (http://creativecommons.org/licenses/by/3.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Research
Motamed, Hassan
Maleki Verki, Mohammadreza
Intravenous Lidocaine Compared to Fentanyl in Renal Colic Pain Management; a Randomized Clinical Trial
title Intravenous Lidocaine Compared to Fentanyl in Renal Colic Pain Management; a Randomized Clinical Trial
title_full Intravenous Lidocaine Compared to Fentanyl in Renal Colic Pain Management; a Randomized Clinical Trial
title_fullStr Intravenous Lidocaine Compared to Fentanyl in Renal Colic Pain Management; a Randomized Clinical Trial
title_full_unstemmed Intravenous Lidocaine Compared to Fentanyl in Renal Colic Pain Management; a Randomized Clinical Trial
title_short Intravenous Lidocaine Compared to Fentanyl in Renal Colic Pain Management; a Randomized Clinical Trial
title_sort intravenous lidocaine compared to fentanyl in renal colic pain management; a randomized clinical trial
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5703759/
https://www.ncbi.nlm.nih.gov/pubmed/29201964
http://dx.doi.org/10.22037/emergency.v5i1.18894
work_keys_str_mv AT motamedhassan intravenouslidocainecomparedtofentanylinrenalcolicpainmanagementarandomizedclinicaltrial
AT malekiverkimohammadreza intravenouslidocainecomparedtofentanylinrenalcolicpainmanagementarandomizedclinicaltrial