From the Research
Lidocaine patches are a safe and effective treatment for managing pain associated with rib contusions and fractures, providing moderate efficacy and localized pain relief without significant systemic effects. The most recent and highest quality study, 1, demonstrates that lidocaine patches result in a sustained reduction in pain, outlasting the duration of therapy.
Key Points
- Lidocaine patches, such as Lidoderm 5%, are used to treat pain associated with rib contusions and fractures
- The standard application involves placing the patch directly over the painful area for 12 hours, followed by a 12-hour patch-free period
- Patients typically use one to three patches simultaneously, depending on the size of the affected area
- Treatment duration generally ranges from 1-2 weeks for contusions and 2-4 weeks for fractures, though this varies based on healing progress
- Lidocaine works by temporarily blocking sodium channels in nerve fibers, reducing pain signal transmission from the injured area
Benefits and Considerations
- Lidocaine patches deliver medication directly to the pain site with minimal systemic absorption, resulting in fewer side effects compared to oral pain medications
- They are particularly beneficial for patients who require localized pain relief without the risks associated with systemic opioid use
- However, patients should be aware that lidocaine patches are complementary to other treatments rather than a complete solution; they work best as part of a comprehensive approach that may include oral analgesics, proper breathing exercises to prevent pulmonary complications, and appropriate activity modification during healing
- As noted in 2, a comprehensive review of current pain management in rib fractures, lidocaine patches are a valuable tool in managing pain and preventing complications such as pneumonia and respiratory failure.
Recommendations
- Lidocaine patches should be considered as a first-line treatment for managing pain associated with rib contusions and fractures, particularly in patients who require localized pain relief without the risks associated with systemic opioid use
- Patients should be closely monitored for efficacy and potential side effects, and treatment should be adjusted as needed to ensure optimal pain management and minimize complications.