Stanislav S W, Childs A
College of Pharmacy, The University of Texas at Austin, 78712, USA.
Brain Inj. 2000 Mar;14(3):261-5. doi: 10.1080/026990500120736.
The objective of this study was to compare the effectiveness and safety of intramuscular droperidol to other intramuscularly administered agents used in the management of acutely agitated patients. Twenty-seven inpatients with a history of brain injury were prospectively monitored over a period of 2 months. Data collected for each episode of agitation include: dose, number of doses, time to achieve an adequate response or calming effect, post-episodic functioning, treatment-emergent side effects, and other patient demographics. A retrospective medical records review was also performed on the same cohort, to compare clinical outcomes associated with other intramuscular agents previously used for acute agitation. Time to achieve calming was significantly shorter with intramuscular droperidol (mean = 27.0 minutes) compared to intramuscular haloperidol, lorazepam, or diphenhydramine (group mean = 36.2 minutes, p = 0.02). Of the three comparative agents, the time to achieve calming was the fastest with lorazepam (mean = 35.0 minutes), and slower with diphenhydramine (mean = 42.6 minutes) and haloperidol (mean = 43.0 minutes). Single doses of droperidol controlled agitation more frequently than did single doses of comparative agents, and there was less post-episodic sedation with droperidol following release from seclusion or restraints. Both groups were similar in regard to the incidence of treatment-emergent events. This data represents the first published experience supporting the effectiveness of droperidol in reducing acute agitation in persons with brain injury. Follow-up studies with prospective, double-blind, parallel treatment groups should be performed to validate these preliminary findings.
本研究的目的是比较肌肉注射氟哌利多与其他用于治疗急性躁动患者的肌肉注射药物的有效性和安全性。对27例有脑损伤病史的住院患者进行了为期2个月的前瞻性监测。收集的每次躁动发作的数据包括：剂量、给药次数、达到充分反应或镇静效果的时间、发作后功能、治疗中出现的副作用以及其他患者人口统计学信息。还对同一队列进行了回顾性病历审查，以比较与先前用于急性躁动的其他肌肉注射药物相关的临床结果。与肌肉注射氟哌啶醇相比，肌肉注射氟哌利多达到镇静的时间显著缩短（平均 = 27.0分钟），而肌肉注射氟哌啶醇、劳拉西泮或苯海拉明（组平均 = 36.2分钟，p = 0.02）。在三种对比药物中，劳拉西泮达到镇静的时间最快（平均 = 35.0分钟），苯海拉明（平均 = 42.6分钟）和氟哌啶醇（平均 = 43.0分钟）较慢。单剂量氟哌利多比单剂量对比药物更频繁地控制躁动，并且在解除隔离或约束后，氟哌利多引起的发作后镇静较少。两组在治疗中出现的事件发生率方面相似。这些数据代表了首次发表的支持氟哌利多在减少脑损伤患者急性躁动方面有效性的经验。应进行前瞻性、双盲、平行治疗组的随访研究以验证这些初步发现。
