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Showing 2 results for Bone Fracture
Hojat Hossein Pourfeizy , Airag Lotfiniya ,
Volume 5, Issue 1 (4-2005)
Abstract
Background & Objectives: Fat embolism syndrome (FES) is mainly due to the obstruction of blood vessels with fat globules, reached to circulation. FES is associated with traumatic and non traumatic diseases. The prevalence is 2-5% in long-bone fractures. The purpose of this study is to evaluate manifestations, laboratory findings and the diagnosed cases of fat embolism. Methods: In this retrospective study all the patient records associated with injury were evaluated and those diagnosed with the traumatic fat embolism were selected. The data including sex, age, type of fracture, clinical and laboratory findings and symptom onset time were collected using a questionnaire. These data were then statistically analyzed. Results: 17 out of 1660 patients were found to have fat embolism most of which belonged to middle-aged men. The most common clinical features consisted of: respiratory failure, tachycardia and consciousness level alterations. Fat embolism was mainly associated with tibial and femoral shaft fractures. Low level of Pao2 (Pao2<60) is the most reliable laboratory test in this study. Conclusion: Fat embolism should be regarded as a threarening factor in patients (especially middle-aged ones) with fractures in long bons of lower limbs. Pao2 Level of can also be used as a reliable laboratory finding.
Mohsen Salehi, Alireza Zeraatchi, Farzaneh Karamitanha, Gholamreza Hamidkholgh,
Volume 25, Issue 2 (7-2025)
Abstract
Background: Effective management of acute pain in patients with long-bone fractures is essential for comfort and procedural facilitation. While intravenous morphine is the gold standard for pain relief, it is associated with significant adverse effects. This study investigates the efficacy and safety of nebulized fentanyl as a noninvasive alternative to intravenous morphine in managing acute pain from long-bone fractures, alongside assessing patient satisfaction.
Methods: In a randomized, double-masked clinical trial conducted in the Emergency Department, 240 patients aged 20–50 years with long-bone fractures and visual analog scale (VAS) pain scores greater than five were randomly assigned to receive either nebulized fentanyl (4 µg/kg) or intravenous morphine (0.1 mg/kg). Pain scores were recorded at baseline and at 5, 10, 15, 30, and 60 minutes after the intervention. Secondary outcomes included the need for rescue analgesia, adverse effects, and patient satisfaction, which were analyzed statistically using a significance level of α = 0.05.
Results: At 5 minutes, the pain intensity difference between groups was Δ5 = x5 units (95% CI: [L5, U5]), and at 60 minutes, Δ60 = x60 units (95% CI: [L60, U60]). The need for rescue analgesia showed numeric differences at 15 and 30 minutes. Nausea/vomiting were more prevalent in the morphine group. Patient satisfaction was comparable between the two groups.
Conclusion: Both nebulized fentanyl and intravenous morphine are effective for acute pain relief, though morphine offers superior early relief. Nebulized fentanyl presents a viable alternative with fewer systemic side effects.
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