Pouraghaei Mahboub, Moharamzadeh Payman, Paknezhad Seyed Pouya, Rajabpour Zahra Vand, Soleimanpour Hassan
Emergency Medicine Research Team, Tabriz University of Medical Sciences, Tabriz, Iran.
Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.
World J Urol. 2021 Apr;39(4):1263-1267. doi: 10.1007/s00345-020-03319-4. Epub 2020 Jun 26.
Urinary stones are a common urologic problem that can be manifested as an intense pain, known as renal colic. Pain control is an important intervention for the emergency treatment of renal colic patients. Intranasal ketamine can form a crucial part of such interventions by offering a new route for a widely-used analgesic drug.
In a double-blind, randomized, clinical trial, adults with renal colic admitted to a tertiary hospital emergency department were examined. The intervention group received 1 mg/kg intranasal (IN) ketamine and 1 ml of saline as a placebo. The control group received 0.1 mg/kg intravenous (IV) morphine and four puffs of saline as the placebo. The pain score was measured on the Numerical Rating Scale (NRS) 0, 15, 30 and 60 min after the drug administration.
A total of 184 patients enrolled in this study in two parallel groups. The two groups did not differ significantly in terms of pain intensity at the time of their referral (P = 0.489), 15 min post-dose (P = 0.204), 30 min post-dose (P = 0.978) and 60 min post-dose (P = 0.648).
IN ketamine is as effective as IV morphine for pain control in renal colic patients. No remarkable side-effects were observed for IN ketamine use in these patients.
尿路结石是一种常见的泌尿系统问题，可表现为剧烈疼痛，即肾绞痛。疼痛控制是肾绞痛患者急诊治疗的重要干预措施。鼻内给予氯胺酮可为这种干预措施提供关键作用，为一种广泛使用的镇痛药开辟新途径。
在一项双盲、随机临床试验中，对一家三级医院急诊科收治的肾绞痛成年患者进行了检查。干预组接受1mg/kg鼻内（IN）氯胺酮和1ml生理盐水作为安慰剂。对照组接受0.1mg/kg静脉注射（IV）吗啡和四喷生理盐水作为安慰剂。在给药后0、15、30和60分钟，使用数字评分量表（NRS）测量疼痛评分。
本研究共纳入184例患者，分为两个平行组。两组在转诊时（P = 0.489）、给药后15分钟（P = 0.204）、给药后30分钟（P = 0.978）和给药后60分钟（P = 0.648）的疼痛强度方面无显著差异。
鼻内氯胺酮在控制肾绞痛患者疼痛方面与静脉注射吗啡同样有效。在这些患者中使用鼻内氯胺酮未观察到明显的副作用。
