Lidocaine Patches for Rib Fracture Pain

Albert B. Lowenfels, MD


March 24, 2010

Randomized Double-Blind Placebo-Controlled Trial Using Lidocaine Patch 5% in Traumatic Rib Fractures

Ingalls NK, Horton ZA, Bettendorf M, Frye I, Rodriguez C
J Am Coll Surg. 2010;210:205-209

Study Summary

The investigators randomly assigned 33 patients with rib fractures to be treated with either a lidocaine patch or a placebo patch (n = 25), to determine the role of intradermal lidocaine in the management of pain following rib fracture. The 2 groups were similar with respect to number of fractured ribs, age, smoking status, and overall injury severity. Evaluation of narcotic use, both intravenous and oral, showed no significant differences between the 2 groups, nor was there any difference in perception of pain as measured with a pain score, pulmonary complications, or length of stay.


Topical lidocaine is absorbed into body fluids, and by stabilizing neuronal receptors, could possibly assist in the management of pain from trauma or surgery. In contrast to other studies, this randomized trial failed to find any benefit from using a single lidocaine skin patch. The sample size is small, so it is possible that a larger trial might have detected a small benefit. Also, increasing the number of patches, thus increasing the dose of lidocaine, might have proved beneficial. Nevertheless, this trial provides no evidence for the value of lidocaine skin patches in managing pain arising from rib fractures.



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