PT  - JOURNAL ARTICLE
AU  - Okan Solak
AU  - Hidir Esme
AU  - Kubilay Ocalan
AU  - H. Volkan Kara
AU  - Nuri Tutar
TI  - Effectiveness of treatment of transdermal narcotics in rib fractures
DP  - 2011 Sep 01
TA  - European Respiratory Journal
PG  - p2403
VI  - 38
IP  - Suppl 55
4099  - http://erj.ersjournals.com/content/38/Suppl_55/p2403.short
4100  - http://erj.ersjournals.com/content/38/Suppl_55/p2403.full
SO  - Eur Respir J2011 Sep 01; 38
AB  - Rib fracture is the most common pathology in thoracic traumas. Severe pain is the most common symptom. The use and dosage of narcotic analgesics in the early period is controversial. Our aim is to investigate the efficacy of transdermal release (TR) narcotics in these patientsThere were consequtive 25 patients who had diagnosis of rib fractures. Patients in group 1 (n=10) had intercostal nerve block (by bupivacain 0.5%), intramuscular narcotic (meperidine) according to the weight of the patient and paracetamol per orally. Patients in group 2 (n=15) intercostal nerve block (by bupivacain 0.5%), transdermal release (TR) narcotics (fentanyl) and paracetamol orally. We used Visual Analog Scale (VAS) for scoring the pain. The efficacy of treatment is evaluated by calculation and scoring of VAS both at exertion and relaxation.The sedation that might be by the narcotic agents was followed by Ramsey Sedation Scale (RSS) and arterial blood gases. The study was ended in the fifthy day.There were no difference for age, gender, type of trauma, additional pathology number of fractured ribs and their localization between the two groups. Both groups had improvement for VAS before and after treatment. The VAS improvement in group 2 was better in both in relaxation and activity for the 5 daysIt is difficult to establish the effective blood levels of parenteral narcotics so that there is continous need for repetative administration of the drugs. In TD applied narcotics the blood levels of the drugs are stable. The use of narcotics transdermally instead of paranteral administration was more effective and comfortable by the way of administration according to our study results.