儿童头痛治疗中使用丙氯拉嗪或甲氧氯普胺致急性肌张力障碍反应。

Acute Dystonic Reactions in Children Treated for Headache With Prochlorperazine or Metoclopramide.

机构信息

Division of Child Neurology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.

出版信息

Pediatr Neurol. 2020 May;106:63-64. doi: 10.1016/j.pediatrneurol.2020.01.013. Epub 2020 Feb 4.

DOI:10.1016/j.pediatrneurol.2020.01.013

PMID:32098684

Abstract

BACKGROUND

The incidences of dystonic reactions to metoclopramide and prochlorperazine have not been well characterized in children.

METHODS

Medical record data were reviewed for patients at a tertiary care pediatric hospital who received metoclopramide or prochlorperazine for treatment of headache.

RESULTS

A total of 4588 clinical encounters were identified, 2542 with prochlorperazine and 2046 with metoclopramide. One patient had a dystonic reaction with metoclopramide (0.049%). Eleven patients had a dystonic reaction with prochlorperazine (0.43%). The relative risk of a dystonic reaction with prochlorperazine over metoclopramide is 8.85 (95% confidence interval 1.15 to 68.5). There were differences between groups of patients who received metoclopramide versus prochlorperazine in terms of age, number of doses, and coadministration of diphenhydramine. In a logistic regression, administration of prochlorperazine over metoclopramide (P = 0.019) and greater number of doses (P < 0.001) remained associated with acute dystonic reactions.

CONCLUSIONS

Dystonic reactions are rare events among pediatric patients treated for acute headache, but are more common with prochlorperazine than metoclopramide.

摘要

背景

儿童中曲坦类药物和丙氯拉嗪引起迟发性运动障碍的发生率尚未得到很好的描述。

方法

对一家三级儿童保健医院接受甲氧氯普胺或丙氯拉嗪治疗头痛的患者的病历数据进行了回顾。

结果

共确定了 4588 次临床就诊，其中 2542 次使用丙氯拉嗪，2046 次使用甲氧氯普胺。1 例患者出现甲氧氯普胺迟发性运动障碍（0.049%）。11 例患者出现丙氯拉嗪迟发性运动障碍（0.43%）。丙氯拉嗪迟发性运动障碍的相对风险为 8.85（95%置信区间 1.15 至 68.5）。接受甲氧氯普胺与丙氯拉嗪的患者在年龄、剂量和合用苯海拉明方面存在差异。在逻辑回归中，与接受甲氧氯普胺相比，接受丙氯拉嗪（P=0.019）和更多剂量（P<0.001）与急性迟发性运动障碍相关。