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静脉注射氯胺酮与静脉注射吗啡对减轻肾绞痛患者疼痛的镇痛效果比较:双盲临床试验研究

Comparison of the Analgesic Effect of Intravenous Ketamine versus Intravenous Morphine in Reducing Pain of Renal Colic Patients: Double-Blind Clinical Trial Study.

作者信息

Forouzan Arash, Masoumi Kambiz, Motamed Hassan, Esfahani Seyed Reza Naji, Delirrooyfard Ali

机构信息

Department of Emergency Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

出版信息

Rev Recent Clin Trials. 2019;14(4):280-285. doi: 10.2174/1574887114666190705122727.

Abstract

BACKGROUND

The effective relief of renal colic patients with low complications is one of the important concerns of emergency physicians. The aim of this study was to investigate the use of injectable ketamine as an alternative to routine drugs in the relief of pain in patients with renal colic.

METHODS

This double-blind clinical trial was conducted on patients who had suffered kidney pain due to kidney stones in 2017, referred to Ahvaz Imam Khomeini Hospital. Patients were divided into 2 groups: the first group received intravenous ketamine (0.3 mg/kg) and the second group received intravenous morphine (0.1 mg/kg) in a double-blind form. Finally, the mean pain was evaluated before injection, after 10, 20, 30, and 60 minutes as the initial result while the side effects were considered as secondary results.

RESULTS

In this study, 135 patients with renal colic participate in this study. The mean pain at the time of referral to the hospital in the group receiving morphine and ketamine was 9.2 and 9.2, respectively, which did not show any significant difference. Based on these findings, there was no significant difference between the factors evaluated during the study of the two groups. Only in the ketamine group, there were 3 cases of nausea and 1 of vomiting. However, there was a significant increase in the need for additional doses of fentanyl in the morphine recipient group (p = 0.02).

CONCLUSION

The findings suggest that the use of ketamine can produce a more rapid relief effect, and decrease the use of opioids which create various complications, including nausea and vomiting in patients, especially patients with renal colic.

摘要

背景

有效缓解并发症少的肾绞痛患者是急诊医生重要的关注点之一。本研究的目的是调查使用注射用氯胺酮作为常规药物的替代药物来缓解肾绞痛患者的疼痛。

方法

这项双盲临床试验针对2017年因肾结石而肾区疼痛并转诊至阿瓦士伊玛目霍梅尼医院的患者进行。患者被分为两组:第一组接受静脉注射氯胺酮(0.3毫克/千克),第二组接受静脉注射吗啡(0.1毫克/千克),采用双盲形式。最后,将注射前、注射后10、20、30和60分钟时的平均疼痛程度作为初始结果进行评估,而副作用则作为次要结果进行考量。

结果

本研究中有135例肾绞痛患者参与。接受吗啡和氯胺酮治疗的两组患者在转诊至医院时的平均疼痛程度分别为9.2和9.2,无显著差异。基于这些发现,两组研究期间评估的因素之间无显著差异。仅在氯胺酮组中,有3例恶心和1例呕吐。然而,吗啡治疗组中额外使用芬太尼的需求显著增加(p = 0.02)。

结论

研究结果表明,使用氯胺酮可产生更快的缓解效果,并减少阿片类药物的使用,阿片类药物会引发各种并发症,包括患者尤其是肾绞痛患者的恶心和呕吐。

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