Lidocaine skin patch [lidopat[registered] 5%] is effective in the treatment of traumatic rib fractures: a prospective double-blinded and vehicle-controlled study

Objective: The purpose of this study was to determine the efficacy of the Lidopat[registered] 5% skin patch in relieving rib fracture pain

Subjects and Methods: From June 2009 to May 2011, 44 trauma patients with isolated rib fractures were enrolled in this study and randomized in a double-blind method into 2 groups. The experimental group [group E: 27 patients] used a Lidopat[registered] 5% skin patch at the trauma site and took an oral analgesic drug for pain relief. The placebo group [group P: 17 patients] used a placebo vehicle patch and an oral analgesic drug

Results: The mean age, weight and hospital stay of patients were 56.8 +/- 13.8 years, 67.4 +/- 12.6 kg and 6.34 +/- 1.3 days, respectively. In the first 4 days, there were no significant differences in pain scores between the groups [p > 0.05]. After the 5th day, the average pain score was significantly less in group E [mean 1.5] than in group P [mean 3.10; p < 0.05]. There was no significant difference in the number of fractured ribs between groups [p = 0.904]. The use of meperidine and the length of hospital stay [6.0 vs. 6.9 days] were both significantly less in group E [p = 0.043 and 0.009, respectively]

Conclusion: In this study, the use of the Lidopat[registered] 5% skin patch in patients with isolated rib fractures alleviated pain and shortened the hospital stay, and a lower dose of pain-relieving medication was used

Unsuspected foreign object in the bronchus

A 20-year-old man had a chest radiograph performed as part of his military service entrance examination. The posterior-anterior [PA] film revealed a linear shadow near the right hilum. Previous chest PA films had no such shadow. The patient could not give any seemingly relevant history. A chest CT scan [10-mm slice thickness] identified the shadow as an intrabronchial lesion, specifically a pin in the right anterior segmental bronchus [B3] [Figure 1]. Fiber bronchoscopic examination revealed the tip of the pin in the orifice of B3 [Figure 2]. The only active bleeding was a mild oozing from surrounding granulation tissue. The whole pin pulled smoothly and easily out of the airway. The pin was 4 centimeters in length. When the patient saw the pin, he recalled an episode of aspiration about 3 months earlier. He had been holding pins in his teeth while sewing a window curtain. A friend suddenly slapped him on the back and he inhaled suddenly and deeply