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巴西急诊科偏头痛治疗:2 个地区的回顾性研究。

Migraine Treatment in Emergency Departments of Brazil: A Retrospective Study of 2 Regions.

机构信息

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.

出版信息

Headache. 2020 Nov;60(10):2413-2420. doi: 10.1111/head.13999. Epub 2020 Oct 27.

Abstract

OBJECTIVE

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.

METHODS

Retrospective, cross-sectional, observational, non-randomized study of migraine patients seen at 2 headache centers in Brazil.

RESULTS

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.

CONCLUSIONS

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.

摘要

目的

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。

方法

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。

结果

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%。

结论

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。

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