Henderson Sean O, Swadron Stuart, Newton Edward
Department of Emergency Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, California 90033, USA.
J Emerg Med. 2002 Oct;23(3):237-41. doi: 10.1016/s0736-4679(02)00524-3.
To compare the analgesic efficacy and tolerability of intravenous (IV) ketorolac tromethamine with IV meperidine in the treatment of biliary colic, a prospective, randomized, double blind study was carried out upon a convenience sample of patients at a large inner city facility. Patients between the ages of 18 and 65 years of age with a history and physical examination consistent with biliary colic were enrolled over a 2-year period. Patients were randomly assigned to receive ketorolac 30 mg IV or meperidine 50 mg IV. Pain was quantified using a 4-point verbal rating system (VRS) as well as a visual analog scale (VAS). Patients were queried about their pain at times 0, 12 h, 1 h, and 2 h after administration of the study medication. Adverse effects were also recorded. A total of 324 patients completed the study protocol with 175 patients receiving ketorolac and 149 receiving meperidine. Patient demographics were similar for both groups with mean age for the ketorolac group of 36.1 years and for the meperidine group of 34.6 years. Both groups were predominantly Latino and over 80% of patients in both groups were female. No significant difference in pain control was found between ketorolac and meperidine in either the VAS or VRS for any time interval studied. The mean change in the VAS at time 2 h was 6.2 cm +/- 3.6 cm for the ketorolac group, compared with 6.7 cm +/- 3.6 cm for the meperidine group (p = 0.25). Although no significant difference was found in overall drug tolerability, patients receiving meperidine reported higher incidences of nausea and of dizziness than those receiving ketorolac (p = 0.009 and 0.003, respectively). Ketorolac tromethamine is a well-tolerated, effective medication in the treatment of acute biliary colic. It showed similar efficacy to meperidine with a decreased number of adverse effects.
为比较静脉注射酮咯酸氨丁三醇与静脉注射哌替啶治疗胆绞痛的镇痛效果和耐受性，在一个大型市中心医疗机构，对一组方便样本患者进行了一项前瞻性、随机、双盲研究。在两年时间里，纳入了年龄在18至65岁之间、病史和体格检查符合胆绞痛的患者。患者被随机分配接受静脉注射30毫克酮咯酸或静脉注射50毫克哌替啶。使用4分言语评定量表（VRS）以及视觉模拟量表（VAS）对疼痛进行量化。在给予研究药物后0小时、1小时、2小时和12小时询问患者的疼痛情况。还记录了不良反应。共有324名患者完成了研究方案，其中175名患者接受酮咯酸治疗，149名患者接受哌替啶治疗。两组患者的人口统计学特征相似，酮咯酸组的平均年龄为36.1岁，哌替啶组为34.6岁。两组主要为拉丁裔，两组中超过80%的患者为女性。在研究的任何时间间隔内，酮咯酸和哌替啶在VAS或VRS上的疼痛控制方面均未发现显著差异。酮咯酸组在2小时时VAS的平均变化为6.2厘米±3.6厘米，而哌替啶组为6.7厘米±3.6厘米（p = 0.25）。虽然在总体药物耐受性方面未发现显著差异，但接受哌替啶的患者报告的恶心和头晕发生率高于接受酮咯酸的患者（分别为p = 0.009和0.003）。酮咯酸氨丁三醇是治疗急性胆绞痛耐受性良好且有效的药物。它显示出与哌替啶相似的疗效，且不良反应数量减少。
