Masoumi Babak, Farzaneh Behdad, Ahmadi Omid, Heidari Farhad
Department of Emergency Medicine, Medical School, Isfahan University of Medical Sciences, Isfahan, Iran.
Adv Biomed Res. 2017 Jul 28;6:91. doi: 10.4103/2277-9175.211832. eCollection 2017.
According to the lack of adequate studies on comparing the analgesic effect and complications of ketorolac with morphine in long bone fractures, this study aimed to compare the efficacy of ketorolac with morphine in patients referring to the Emergency Department with long bones damage and fracture.
In this clinical trial study, 88 patients with long bone fracture were selected randomly and divided into two groups. To scale the intensity of pain, visual analog scale (VAS) were used. Intravenous ketorolac and morphine with the loading dose of 10 mg and 5 mg, respectively was administered to a group, followed by 5 mg and 2.5 mg every 5-20 min, if necessary (VAS ≥4). The pain scores before injection and at 5 min, half an hour and 1-h after the injection were measured and recorded for all patients.
The mean age of the ketorolac and morphine groups was 29.1 ± 12.5 and 33.2 ± 11.4, respectively. In the groups, there was 63.6% and 70.5% of male patients respectively. The mean ± SD of pain score before the injection was 7.59 ± 1 and 7.93 ± 1.09 ( = 0.13). One hour after the injection, the mean ± SD of pain in the both groups was 1.41 ± 0.9 and 1.61 ± 1.17 and the mean pain score has no significant difference in the two groups before the injection. Repeated measures ANOVA test also showed that the trend of changes in pain score had no significant difference in both groups ( = 0.08).
According to the fewer side effects of ketorolac and effective pain release versus morphine, ketorolac could be suggested to use.
鉴于缺乏关于酮咯酸与吗啡在长骨骨折中镇痛效果及并发症比较的充分研究，本研究旨在比较酮咯酸与吗啡在因长骨损伤和骨折就诊于急诊科患者中的疗效。
在这项临床试验研究中，88例长骨骨折患者被随机选取并分为两组。采用视觉模拟评分法（VAS）来衡量疼痛强度。一组分别给予静脉注射负荷剂量为10mg的酮咯酸和5mg的吗啡，必要时（VAS≥4）每5 - 20分钟再分别给予5mg和2.5mg。测量并记录所有患者注射前以及注射后5分钟、半小时和1小时的疼痛评分。
酮咯酸组和吗啡组的平均年龄分别为29.1±12.5岁和33.2±11.4岁。两组中男性患者分别占63.6%和70.5%。注射前疼痛评分的平均值±标准差分别为7.59±1和7.93±1.09（P = 0.13）。注射后1小时，两组疼痛的平均值±标准差分别为1.41±0.9和1.61±1.17，且两组注射前的平均疼痛评分无显著差异。重复测量方差分析也表明两组疼痛评分的变化趋势无显著差异（P = 0.08）。
鉴于酮咯酸副作用较吗啡少且能有效缓解疼痛，建议使用酮咯酸。
