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氯诺昔康联合小剂量氯胺酮与哌替啶用于控制急性肾绞痛疼痛的比较

Lornoxicam with Low-Dose Ketamine versus Pethidine to Control Pain of Acute Renal Colic.

作者信息

Metry Ayman A, Fahmy Neven G, Nakhla George M, Wahba Rami M, Ragaei Milad Z, Abdelmalek Fady A

机构信息

Department of Anesthesia, ICU and Pain Management, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

出版信息

Pain Res Treat. 2019 Mar 13;2019:3976027. doi: 10.1155/2019/3976027. eCollection 2019.

Abstract

OBJECTIVES

This study was established to compare single-dose lornoxicam 8 mg (NSAID) in addition to 0.15 mg.kg ketamine with single-dose pethidine 50 mg, both administered intravenously (IV), on the quickness and extent of analgesia, disadvantage, and consequence on utilitarian situation.

PATIENTS AND METHODS

One hundred and twenty patients with acute renal colic pain received in emergency room were included in this prospective, randomized, and double blind clinical study. They were aimlessly designated into one of two groups using a computer-generated table. Group L received lornoxicam 8 mg IV plus 0.15 mg.kg ketamine and Group P received pethidine 50 mg IV. Parameters were noticed at baseline and after 0, 15, 30, and 45 minutes and 1 hour after drug administration. The efficiency of the drug was determined by observing: patient rated pain, time to pain relief, rate of pain recurrence, the need for rescue analgesia, adverse events, and functional status.

RESULTS

The visual analogue scale was significantly lower in Group L after 30 minutes in comparison to Group P. In addition, there was statistically significant increase in Group P regarding their need for rescue analgesia after 30 min in comparison to Group L. Group P showed nonsignificantly increased sedation score compared to Group L.

CONCLUSION

Patients receiving lornoxicam-ketamine attained greater reduction in pain scores and less side effects with better functional state and also are less likely to require further analgesia than those administered pethidine to control acute renal colic pain.

摘要

目的

本研究旨在比较静脉注射(IV)单剂量8毫克氯诺昔康(一种非甾体抗炎药)加0.15毫克/千克氯胺酮与单剂量50毫克哌替啶在镇痛速度、程度、不良反应及对功能状态影响方面的差异。

患者与方法

本前瞻性、随机、双盲临床研究纳入了120名在急诊室接受治疗的急性肾绞痛患者。使用计算机生成的表格将他们随机分为两组。L组接受静脉注射8毫克氯诺昔康加0.15毫克/千克氯胺酮,P组接受静脉注射50毫克哌替啶。在基线以及给药后0、15、30、45分钟和1小时记录各项参数。通过观察以下指标来确定药物疗效:患者自评疼痛程度、疼痛缓解时间、疼痛复发率、急救镇痛需求、不良事件及功能状态。

结果

30分钟后,L组的视觉模拟评分显著低于P组。此外,与L组相比,P组在30分钟后急救镇痛需求在统计学上有显著增加。与L组相比,P组的镇静评分虽有增加但无统计学意义。

结论

与接受哌替啶治疗以控制急性肾绞痛的患者相比,接受氯诺昔康 - 氯胺酮治疗的患者疼痛评分降低幅度更大,副作用更少,功能状态更好,且更不太可能需要进一步镇痛。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/837c/6436326/055b6e535fb3/PRT2019-3976027.001.jpg

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