Efficacy of Transdermal Lidocaine Patch for Acute Musculoskeletal Pain in the Surgical Setting: A Randomized Pilot Study

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Dr Girge Advait , Dr H V Nerlekar , Dr Sai Vishwas M


To assess the effectiveness of combining transdermal lidocaine with ibuprofen versus ibuprofen alone in managing acute musculoskeletal pain among patients in an Emergency Department (ED) setting. This preliminary investigation was conducted at a single tertiary center ED. Participants: Individuals presenting with acute, isolated musculoskeletal pain lasting up to seven days were evaluated for eligibility. Inclusion criteria comprised being aged 18 years or older, proficient in English, and having no previous ED visits for the presenting complaint. Exclusion criteria encompassed pregnancy or breastfeeding, presence of open wounds over the painful area, end-stage renal disease, diabetes, and recent use of opioids, muscle relaxants, or ibuprofen prior to enrollment. Intervention: Patients were randomly assigned to either: (1) ibuprofen alone or (2) a combination of transdermal lidocaine patch and ibuprofen. Primary outcome measure was patient-reported pain level one-hour post-medication administration. Secondary endpoints included baseline pain intensity and change in pain score from baseline. Findings: Analysis of data from 17 patients indicated a reduction in average pain scores by 2 points in the control group (± 2.8), compared to 1.6 points (± 0.9) in the lidocaine patch group (p=0.17). Although there was no statistically significant difference in mean pain scores between the two groups at baseline (6.7 ± 1.9 vs. 7.4 ± 1.9; p=0.46) or at one-hour post-treatment (4.1 ± 2.9 vs. 5.6 ± 1.9; p=0.26), the lidocaine patch group exhibited less variability, as evidenced by a narrower 95% confidence interval. While the addition of lidocaine patch to ibuprofen did not demonstrate a statistically significant improvement in pain scores compared to ibuprofen alone, there was a more consistent reduction in pain, suggesting potential for enhanced pain management consistency. Further exploration through a larger multicenter trial is warranted to ascertain the effectiveness of transdermal lidocaine as an adjunctive therapy for acute musculoskeletal pain.

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Dr Sai Vishwas M , D. G. A. , D. H. V. N. ,. (2024). Efficacy of Transdermal Lidocaine Patch for Acute Musculoskeletal Pain in the Surgical Setting: A Randomized Pilot Study. Obstetrics and Gynaecology Forum, 34(3s), 1028–1031. Retrieved from http://obstetricsandgynaecologyforum.com/index.php/ogf/article/view/414

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