Department of Neurology, Headache Center of Rio, Rio de Janeiro, Brazil.
Center of Neurology and Headache of Piauí, Universidade Federal do Delta do Parnaíba, Teresina, Piauí, Brazil.
Headache. 2020 Nov;60(10):2413-2420. doi: 10.1111/head.13999. Epub 2020 Oct 27.
This study describes the approaches, medications used, and time of care for migraineurs, who have been in emergency departments (ED) from 2 different regions of Brazil.
Retrospective, cross-sectional, observational, non-randomized study of migraine patients seen at 2 headache centers in Brazil.
Eighty-four migraine patients (15 men and 69 women) were divided into 2 groups: chronic (19%, n = 16) and episodic migraineurs (81%, n = 68). In the ED, medications were used in the following order of frequency: dipyrone or metamizole (89.3%, 75/84), nonsteroidal anti-inflammatory drugs (57.1%; 48/84) opioids (51.1%; 43/84), metoclopramide (29.8%; 25/84), dexamethasone (28.6%; 24/84), chlorpromazine (13.1%; 11/84), and subcutaneous sumatriptan (7.1%; 6/84). The average time in the care center was 8.2 hours, but only 23 patients (27.4%) left the hospital with greater than 50% relief in headache severity.
Dipyrone and nonsteroidal anti-inflammatories were the most used drugs, but nearly half received opioids. More efficient drugs were poorly used. Considering the number of patients leaving the hospital with headache relief, a changing treatment paradigm should be carried out in Brazil.
本研究描述了来自巴西两个地区的急诊就诊偏头痛患者的就诊途径、使用的药物和治疗时间。
这是一项回顾性、横断面、观察性、非随机研究,纳入了巴西两个头痛中心的偏头痛患者。
84 例偏头痛患者(15 例男性和 69 例女性)分为两组:慢性偏头痛患者(19%,16 例)和发作性偏头痛患者(81%,68 例)。在急诊科,药物的使用频率依次为:双氯芬酸或甲灭酸(89.3%,75/84)、非甾体类抗炎药(57.1%,48/84)、阿片类药物(51.1%,43/84)、甲氧氯普胺(29.8%,25/84)、地塞米松(28.6%,24/84)、氯丙嗪(13.1%,11/84)和皮下舒马曲坦(7.1%,6/84)。在治疗中心的平均治疗时间为 8.2 小时,但只有 23 例(27.4%)患者的头痛严重程度缓解超过 50%。
双氯芬酸和非甾体类抗炎药是最常用的药物,但近一半患者使用了阿片类药物。效率更高的药物使用不足。考虑到有多少患者出院时头痛缓解,巴西应该改变治疗模式。