Ghafouri Hamed Basir, Abazarian Niloofar, Yasinzadeh Mohammadreza, Modirian Ehsan
Emergency Medicine, Trauma and Injury Research Center, Iran University of Medical Sciences, Tehran, Iran.
Emergency Medicine, Alborz University of Medical Sciences, Karaj, Iran.
Pain Med. 2020 Dec 25;21(12):3437-3442. doi: 10.1093/pm/pnaa240.
To evaluate the analgesic efficacy of intranasal desmopressin alone vs intravenous paracetamol in patients referred to the emergency department with renal colic.
Randomized clinical trial.
This study was conducted in the emergency unit of a university hospital.
Patients referred to the emergency room with renal colic.
Effect of intranasal desmopressin in pain relief in comparison with intravenous paracetamol.
In this trial, 240 patients diagnosed with renal colic were randomly divided into two groups to compare the analgesic effect of intravenous paracetamol (15 mg/kg) and intranasal desmopressin spray (40 μg). Pain scores were measured by a numeric rating scale at baseline and after 15, 30, and 60 minutes. Adverse effects and need for rescue analgesic (0.05 mg/kg max 3 mg morphine sulphate) were also recorded at the end of the study.
Three hundred patients were eligible for the study; however, 240 were included in the final analysis. The patients in the two groups were similar in their baseline characteristics and baseline pain scores. The mean pain score after 15 minutes was more reduced and was clinically significant (>3) in the desmopressin group (P < 0.0001). There was no significant difference between mean pain scores in the two groups after 30 minutes (P = 0.350) or 60 minutes (P = 0.269), but the efficacy of the two drugs was significant in terms of pain reduction (>6).
Our study showed that intranasal desmopressin is as effective as intravenous paracetamol for renal colic pain management; however, significant clinical reduction in pain score occurred faster with intranasal desmopressin.
评估在因肾绞痛前往急诊科就诊的患者中，单独使用鼻内去氨加压素与静脉注射对乙酰氨基酚的镇痛效果。
随机临床试验。
本研究在一家大学医院的急诊科进行。
因肾绞痛前往急诊室就诊的患者。
与静脉注射对乙酰氨基酚相比，鼻内去氨加压素在缓解疼痛方面的效果。
在本试验中，240例被诊断为肾绞痛的患者被随机分为两组，以比较静脉注射对乙酰氨基酚（15mg/kg）和鼻内去氨加压素喷雾剂（40μg）的镇痛效果。在基线以及15、30和60分钟后，通过数字评分量表测量疼痛评分。在研究结束时，还记录了不良反应以及使用解救镇痛药（最大0.05mg/kg，最多3mg硫酸吗啡）的情况。
300例患者符合研究条件；然而，最终分析纳入了240例。两组患者的基线特征和基线疼痛评分相似。去氨加压素组在15分钟后的平均疼痛评分降低得更多，且具有临床显著性（>3）（P<0.0001）。30分钟（P=0.350）或60分钟（P=0.269）后，两组的平均疼痛评分无显著差异，但两种药物在减轻疼痛方面（>6）均有显著效果。
我们的研究表明，鼻内去氨加压素在管理肾绞痛疼痛方面与静脉注射对乙酰氨基酚一样有效；然而，鼻内去氨加压素能更快地使疼痛评分出现显著的临床降低。
