Cardozo Alejandro, Silva Carlos, Dominguez Luis, Botero Beatriz, Zambrano Paulo, Bareno Jose
Emergency Department, Clinica Las Vegas, Medellin, Colombia.
Epidemiology Department, Universidad CES, Medellin, Colombia.
World J Emerg Med. 2014;5(4):275-8. doi: 10.5847/wjem.j.issn.1920-8642.2014.04.006.
Mild to moderate musculoskeletal trauma is a common cause for an emergency room visit, and frequent pain is one of the cardinal symptoms of consultation. The objective of this study is to assess the perception of a single subcutaneous dose of 50 mg tramadol for pain management in patients with mild to moderate musculoskeletal trauma, likewise to appraise the perception of pain by subcutaneous injection.
A total of 77 patients, who met inclusion criteria, received a single subcutaneous dose of tramadol. Pain control was evaluated based on the verbal numerical pain scale (0-10) at baseline, 20 and 60 minutes; similarly, pain perception was evaluated secondary to subcutaneous injection of the analgesic.
On admission, the average pain perceived by patients was 8; twenty minutes later, 89% of the patients reported five or less, and after sixty minutes, 94% had three or less on the verbal numerical pain scale. Of the patients, 88% reported pain perception by verbal numeric scale of 3 or less by injection of the drug, and 6.5% required a second analgesic for pain control. Two events with drug administration (soft tissue infection and mild abdominal rectus injection) were reported.
We conclude that a single subcutaneous dose of tramadol is a safe and effective option for the management of patients with mild to moderate pain and musculoskeletal disease in the emergency department.
轻至中度肌肉骨骼创伤是急诊室就诊的常见原因,频繁疼痛是就诊的主要症状之一。本研究的目的是评估单次皮下注射50毫克曲马多对轻至中度肌肉骨骼创伤患者疼痛管理的效果,同时评估皮下注射时的疼痛感受。
共有77名符合纳入标准的患者接受了单次皮下注射曲马多。在基线、20分钟和60分钟时,根据言语数字疼痛量表(0-10)评估疼痛控制情况;同样,在皮下注射镇痛药后评估疼痛感受。
入院时,患者的平均疼痛评分为8分;20分钟后,89%的患者报告疼痛评分为5分或更低,60分钟后,94%的患者报告疼痛评分为3分或更低。在患者中,88%报告注射药物后言语数字疼痛量表评分为3分或更低,6.5%的患者需要第二种镇痛药来控制疼痛。报告了两起与药物给药相关的事件(软组织感染和轻度腹直肌注射)。
我们得出结论,单次皮下注射曲马多是急诊科管理轻至中度疼痛和肌肉骨骼疾病患者的一种安全有效的选择。