Skip to main content

Research Repository

Advanced Search

The Randomised Evaluation of early topical Lidocaine patches In Elderly patients admitted to hospital with rib Fractures (RELIEF): Feasibility trial protocol

Lewis, Amanda; Clout, Madeleine; Benger, Jonathan; Braude, Philip; Turner, Nicholas; Gagg, James; Gendall, Emma; Holloway, Simon; Ingram, Jenny; Kandiyali, Rebecca; Maskell, Nick; Shipway, David; Smith, Jason E; Taylor, Jodi; Darweish-Medniuk, Alia; Carlton, Edward

The Randomised Evaluation of early topical Lidocaine patches In Elderly patients admitted to hospital with rib Fractures (RELIEF): Feasibility trial protocol Thumbnail


Authors

Amanda Lewis

Madeleine Clout

Jonathan Benger

Philip Braude

Nicholas Turner

James Gagg

Emma Gendall

Simon Holloway

Jenny Ingram

Rebecca Kandiyali

Nick Maskell

David Shipway

Jason E Smith

Jodi Taylor

Alia Darweish-Medniuk

Edward Carlton



Abstract

BackgroundTopical lidocaine patches, applied over rib fractures, have been suggested as a non-invasive method of local anaesthetic delivery to improve respiratory function, reduce opioid consumption and consequently reduce pulmonary complications. Older patients may gain most benefit from improved analgesic regimens yet lidocaine patches are untested as an early intervention in the Emergency Department (ED). The aim of this trial is to investigate uncertainties around trial design and conduct, to establish whether a definitive randomised trial of topical lidocaine patches in older patients with rib fractures is feasible.MethodsRELIEF is an open label, multicentre, parallel group, individually randomised, feasibility randomised controlled trial with economic scoping and nested qualitative study. Patients aged ≥ 65 years presenting to the ED with traumatic rib fracture(s) requiring admission will be randomised 1:1 to lidocaine patches (intervention), in addition to standard clinical management, or standard clinical management alone. Lidocaine patches will be applied immediately after diagnosis in ED and continued daily for 72 hours or until discharge. Feasibility outcomes will focus on recruitment, adherence and follow-up data with a total sample size of 100. Clinical outcomes, such as 30-day pulmonary complications, and resource use will be collected to understand feasibility of data collection. Qualitative interviews will explore details of the trial design, trial acceptability and recruitment processes. An evaluation of the feasibility of measuring health economics outcomes data will be completed.DiscussionInterventions to improve outcomes in elderly patients with rib fractures are urgently required. This feasibility trial will test a novel early intervention which has the potential of fulfilling this unmet need. The Randomised Evaluation of early topical Lidocaine patches In Elderly patients admitted to hospital with rib Fractures (RELIEF) feasibility trial will determine whether a definitive trial is feasible.Isrctn registrationISRCTN14813929 (22/04/2021).

Citation

Lewis, A., Clout, M., Benger, J., Braude, P., Turner, N., Gagg, J., …Carlton, E. (2023). The Randomised Evaluation of early topical Lidocaine patches In Elderly patients admitted to hospital with rib Fractures (RELIEF): Feasibility trial protocol. NIHR Open Research, 3, Article 38. https://doi.org/10.3310/nihropenres.13438.2

Journal Article Type Article
Acceptance Date Sep 5, 2023
Online Publication Date Sep 25, 2023
Publication Date Sep 25, 2023
Deposit Date Nov 10, 2023
Publicly Available Date Nov 14, 2023
Journal NIHR open research
Print ISSN 2633-4402
Electronic ISSN 2633-4402
Publisher Taylor and Francis
Peer Reviewed Peer Reviewed
Volume 3
Article Number 38
DOI https://doi.org/10.3310/nihropenres.13438.2
Keywords Feasibility, Frailty, Rib Fractures, Randomised Controlled Trial, Lidocaine Patch
Public URL https://uwe-repository.worktribe.com/output/11409245
PMID 37881461

Files





You might also like



Downloadable Citations