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12岁以上患者雾化芬太尼与静脉注射酮咯酸治疗肾绞痛的疗效比较。

Comparison of efficacy nebulized fentanyl with intravenous ketorolac for renal colic in patients over 12 years old.

作者信息

Rezaei Bareza, Salimi Rasoul, Kalantari Alireza, Astaraki Peyman

机构信息

Clinical Research Development Center of Taleghani, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Department of Emergency Medicine, School of Medicine, Besat Hospital, Hamedan University of Medical Sciences, Hamedan, Iran.

出版信息

Am J Emerg Med. 2021 Jun;44:358-361. doi: 10.1016/j.ajem.2020.04.053. Epub 2020 Apr 21.

Abstract

OBJECTIVES

Acute renal colic is one of the common causes of referral to the hospitals. The aim of this study is to compare the efficacy of nebulized fentanyl with that of intravenous ketorolac in renal colic patients.

MATERIALS & METHODS: This double-blinded clinical study included 186 patients with acute renal colic who were referred to the emergency department of Besat Hospital, Iran.

PATIENT SELECTION

After selecting patients, according to study inclusion and exclusion criteria, they were divided into 2 groups of 93 using random block allocation method. The patients in the groups were treated with either nebulized fentanyl or intravenous ketorolac. The severity of pain was measured using the Numeric Pain Rating Scale (NPRS) of pain. The severity of pain at different times and demographic data were recorded.

RESULTS

One hundred and thirty four males and 52 females with a mean age of 42.95 ± 13.13 years were included in the study. The two groups were matched in terms of age, sex, and the severity of the pain before the treatment. Fifteen minutes following the treatment, the severity of pain was decreased in the ketorolac group but did not change in the nebulized fentanyl group. Thirty minutes after the administration of the drug, the severity of pain in the nebulized fentanyl group decreased. At any time, the severity of pain in the ketorolac group was lower than that of the nebulized fentanyl group.

CONCLUSION

Intravenous ketorolac had better analgesic effects in renal colic patients compared with nebulized fentanyl. Further studies that include complications and combinational therapy are required.

摘要

目的

急性肾绞痛是患者转诊至医院的常见原因之一。本研究旨在比较雾化芬太尼与静脉注射酮咯酸对肾绞痛患者的疗效。

材料与方法

这项双盲临床研究纳入了186例急性肾绞痛患者,这些患者均被转诊至伊朗贝萨特医院急诊科。

患者选择

根据研究纳入和排除标准选择患者后,采用随机区组分配法将他们分为两组,每组93例。两组患者分别接受雾化芬太尼或静脉注射酮咯酸治疗。使用数字疼痛评分量表(NPRS)测量疼痛严重程度。记录不同时间的疼痛严重程度和人口统计学数据。

结果

本研究共纳入134例男性和52例女性,平均年龄为(42.95 ± 13.13)岁。两组在年龄、性别和治疗前疼痛严重程度方面相匹配。治疗15分钟后,酮咯酸组疼痛严重程度降低,而雾化芬太尼组未发生变化。给药30分钟后,雾化芬太尼组疼痛严重程度降低。在任何时间点,酮咯酸组的疼痛严重程度均低于雾化芬太尼组。

结论

与雾化芬太尼相比,静脉注射酮咯酸对肾绞痛患者具有更好的镇痛效果。需要进一步开展包括并发症和联合治疗的研究。

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