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经皮冠状动脉介入治疗期间氧气的镇痛作用(OXYPAIN试验)

The analgesic effect of oxygen during percutaneous coronary intervention (the OXYPAIN Trial).

作者信息

Zughaft David, Bhiladvala Pallonji, Van Dijkman Anna, Harnek Jan, Madsen Hardig Bjarne, Bjork Jonas, Ekelund Ulf, Erlinge David

机构信息

Department of Cardiology, Lund University, Sweden.

出版信息

Acute Card Care. 2013 Sep;15(3):63-8. doi: 10.3109/17482941.2013.822083.

Abstract

INTRODUCTION

Oxygen is considered to have analgesic effects, but the evidence is weak. Oxygen may be harmful to the ischemic myocardium. The aim was to investigate the analgesic effect of oxygen during percutaneous coronary intervention (PCI) and to evaluate cardiac injury.

MATERIAL AND METHODS

The OXYPAIN was a phase II randomized trial with a double blind design. 305 patients were randomized to receive oxygen or atmospheric air during PCI. The patients were asked to score chest pain by the Visual-Analog Scale (VAS). The use of analgesic agents and troponin-t was measured.

RESULTS

There was no significant difference in pain between the groups: oxygen: 2.0, [2.0-4.0], air: 2.0, [2.0-5.0] (median, interquartile range: 25-75%, P = 0.12). The median difference in score of VAS was [95% CI]: 0, [0-1.0]. The oxygen group received 0.44 ± 0.11 mg of morphine versus 0.46 ± 0.13, P = n.s. The peak value of troponin-t post-PCI was 38, [11-352] nmol/ml in the oxygen group and 61, [16-241] for patients treated with air, P = 0.46.

CONCLUSIONS

The use of oxygen during PCI did not demonstrate any analgesic effect. There was no difference in myocardial injury measured with troponin-t or in the morphine dose. Our results do not support routine use of oxygen. (NCT01413841.).

摘要

引言

氧气被认为具有镇痛作用,但证据不足。氧气可能对缺血心肌有害。目的是研究经皮冠状动脉介入治疗(PCI)期间氧气的镇痛作用并评估心脏损伤。

材料与方法

OXYPAIN是一项采用双盲设计的II期随机试验。305例患者在PCI期间被随机分配接受氧气或空气。要求患者通过视觉模拟量表(VAS)对胸痛进行评分。测量了镇痛药的使用情况和肌钙蛋白t水平。

结果

两组之间疼痛无显著差异:氧气组:2.0,[2.0 - 4.0],空气组:2.0,[2.0 - 5.0](中位数,四分位间距:25 - 75%,P = 0.12)。VAS评分的中位数差异为[95%置信区间]:0,[0 - 1.0]。氧气组接受了0.44±0.11毫克吗啡,而空气组为0.46±0.13毫克,P =无显著差异。PCI后氧气组肌钙蛋白t的峰值为38,[11 - 352]纳摩尔/毫升,空气治疗组患者为61,[16 - 241],P = 0.46。

结论

PCI期间使用氧气未显示出任何镇痛效果。在肌钙蛋白t测量的心肌损伤或吗啡剂量方面没有差异。我们的结果不支持常规使用氧气。(NCT01413841.)

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