RT Journal Article
SR Electronic
T1 Effectiveness of treatment of transdermal narcotics in rib fractures
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP p2403
VO 38
IS Suppl 55
A1 Okan Solak
A1 Hidir Esme
A1 Kubilay Ocalan
A1 H. Volkan Kara
A1 Nuri Tutar
YR 2011
UL http://erj.ersjournals.com/content/38/Suppl_55/p2403.abstract
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.