الفهرس 
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Abstract
Background: Pain is defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage. It is considered the most common presenting complaint in the emergency department ( ED ) , The Choice of proper analgesia depends on its safety, efficacy, cost and availability. Nonsteroidal anti-inflamatory drugs (NSAIDs) have been recommended as the first line for managing pain. However, Opioids are often used in many cases of moderate to severe acute pain. Intravenous lidocaine can be used as an analgesic even an opioid alternative. Analgesic action of lidocaine is targeting the acutely injured tissues, also has anti-inflamatory effect which makes it specific and a good choice for managing acute pain. The aim of the work: The purpose of the work is to evaluate intravenous lidocaine’s safety and efficacy as an analgesic agent in the treat¬ment of a variety of acutely painful conditions presenting to Emergency Hospital Mansoura University. Patients: This observational cross-sectional non-controlled study was conducted at Mansoura University Emergency Hospital (MUEH). This study were conducted on 164 cases of acute pain ( traumatic or non traumatic causes ) arrived to the Emergency Room (ER). An approval from the research ethics committee in faculty of medicine, Mansoura University was obtained to conduct this work.
Methods: Patients are devided into two grops : group I received Ketoprofen as NSAIDs by intravenous infusion ove 30 minutes, and group I I received lidocaine intravenous infusion over 30 minutes by the dose of 1.5 mg/kg. All patients subjected to resuscitation, history taking, clinical examination, laboratory and radiological investigations. Results: In the present study, there is no significant difference in the analgesic effect between the two study groups ( NSAIDs group and lidocaine group ), But there is significant difference in opioid use between the two grops as follow :In NSAIDs group 20. % of cases used opiods, wjile in lidocaine group only 7.3 % of cases needed further opioid analgesia. Conclusion: There was no significant difference between the patients who received NSAIDs or who received lidocaine either before of after treatment as regarding the decrease in pain score. However, the use of lidocaine as an initial analgesic decrease the extra requirement of opioids as compaired with NSAIDs. Recommendations: Emergency physicians should consider using lidocaine by the dose of 1.5mg/kg for acute pain control in ED to decrease opioid use, also further studies should be performed on lidocaine including larger number of patients with different drug concentrations to determine the optimal dose for pain control.