Lidocaine Patches in Elderly Patients With Traumatic Rib Fractures

Many patients are prescribed lidocaine patches for rib fractures despite mixed evidence to their efficacy. The outcome of this trial offers significant benefit to patient care if it finds benefit of their use or if it does not. Reducing opioid use and increasing functional outcomes in geriatric patient suffering rib fractures can improve quality of life and ability to return to prior levels of function. Limiting the need for opioid prescriptions dispensed in the community, particularly to vulnerable geriatric individuals, is also a key aspect in curbing the opioid epidemic. However, even if no difference is found, it would support stopping the use of lidocaine patches in this population as a waste of money and resources. The novel approach of adding the 3rd arm to assess for placebo effect will also carry clinical value, as a placebo effect that reduces opioid use may in fact be enough to support continued use of the products given their overall low side effect risk profile compared to opioids and other pain control medications.

Inclusion Criteria: * age\>/= 65 years * Patients with injuries meeting an AIS score \/= 30 mg oral morphine equivalent * History of allergic reaction to lidocaine or adhesive tape * Prisoners * Patient will be excluded if pain is worse in non-ribs location * Patient will be excluded if he has injuries not meeting our criteria