Stiell I G, Dufour D G, Moher D, Yen M, Beilby W J, Smith N A
Department of Emergency Medicine, Ottawa Civic Hospital, University of Ottawa, Ontario, Canada.
Ann Emerg Med. 1991 Nov;20(11):1201-5. doi: 10.1016/s0196-0644(05)81471-4.
To compare the effectiveness of IM administration of methotrimeprazine, a non-narcotic, nonaddicting phenothiazine derivative, with that of a combination of meperidine and dimenhydrinate in the treatment of severe migraine.
Double-blind, randomized, controlled trial.
University hospital emergency department.
Consecutive adult patients with migraine who met eligibility criteria.
Random allocation to receive IM injections of either 37.5 mg methotrimeprazine (Levoprome, Nozinan) or 75 mg meperidine (Demerol) combined with 50 mg dimenhydrinate (Dramamine, Gravol).
The 37 patients in each group who completed the study were similar in all demographic and clinical characteristics. There were no statistical differences in pain intensity one hour after treatment, change in pain intensity, or pain relief as measured on a visual-analog scale; need for additional analgesia; persistence of nausea or vomiting; adverse effects; or follow-up status, except for prolonged drowsiness, in the group receiving methotrimeprazine.
Methotrimeprazine is comparable to meperidine with dimenhydrinate for treating severe migraine and may be considered an effective, nonaddicting, IM alternative to narcotics for the management of this problem.
比较非麻醉性、无成瘾性的吩噻嗪衍生物美索达嗪肌内注射与哌替啶和茶苯海明联合用药治疗重度偏头痛的有效性。
双盲、随机、对照试验。
大学医院急诊科。
符合入选标准的连续性成年偏头痛患者。
随机分配接受37.5毫克美索达嗪（左美丙嗪、诺嗪）或75毫克哌替啶（度冷丁）加50毫克茶苯海明（乘晕宁、晕海宁）的肌内注射。
每组完成研究的37例患者在所有人口统计学和临床特征方面相似。在视觉模拟量表上测量，治疗后1小时的疼痛强度、疼痛强度变化或疼痛缓解情况；是否需要额外镇痛；恶心或呕吐的持续时间；不良反应；或随访状态，除了接受美索达嗪治疗的组有嗜睡时间延长外，均无统计学差异。
美索达嗪在治疗重度偏头痛方面与哌替啶加茶苯海明相当，可被视为治疗该疾病的一种有效、无成瘾性的肌内注射替代麻醉药物。
