Larkin G L, Prescott J E
Department of Surgery, West Virginia University Health Sciences Center, Morgantown.
Ann Emerg Med. 1992 Aug;21(8):919-24. doi: 10.1016/s0196-0644(05)82928-2.
To evaluate the relative efficacy of ketorolac tromethamine and meperidine hydrochloride in the emergency department treatment of severe migraine.
Prospective, randomized, double-blind trial.
University hospital ED.
Patients presenting to the ED with an isolated diagnosis of common or classic migraine.
Subjects were randomized to receive a single intramuscular injection of either 30 mg ketorolac or 75 mg meperidine.
Of the 31 patients completing the trial, 15 received ketorolac and 16 received meperidine. The demographic characteristics of both groups were comparable. At one hour, ketorolac was significantly less effective than meperidine in reducing headache pain (P = .02) and in improving clinical disability (P = .01). Ketorolac also was less effective at reducing nausea, photophobia, and the need for rescue medication (P less than .05). Sustained headache relief was experienced by 44% of the patients treated with meperidine at 12- to 24-hour follow-up, compared with 13% of the patients treated with ketorolac (P = NS). No significant side effects were observed for either group.
IM ketorolac tromethamine is less effective than meperidine in the ED treatment of severe migraine.
评估急诊室中用酮咯酸氨丁三醇和盐酸哌替啶治疗重度偏头痛的相对疗效。
前瞻性、随机、双盲试验。
大学医院急诊科。
因单纯诊断为普通型或典型偏头痛而到急诊科就诊的患者。
受试者被随机分配接受单次肌肉注射30毫克酮咯酸或75毫克哌替啶。
31名完成试验的患者中，15名接受了酮咯酸治疗，16名接受了哌替啶治疗。两组的人口统计学特征具有可比性。在1小时时，酮咯酸在减轻头痛疼痛方面（P = 0.02）以及改善临床功能障碍方面（P = 0.01）明显不如哌替啶有效。酮咯酸在减轻恶心、畏光以及减少使用急救药物方面也效果较差（P < 0.05）。在12至24小时的随访中，接受哌替啶治疗的患者中有44%的人头痛持续缓解，而接受酮咯酸治疗的患者中这一比例为13%（P = 无显著性差异）。两组均未观察到明显的副作用。
在急诊科治疗重度偏头痛时，肌肉注射酮咯酸氨丁三醇的效果不如哌替啶。
