Cowling Matt, Covington Stephen, Roehmer Christian, Musey Paul
School of Medicine, Indiana University, Indianapolis, Indiana, USA.
St Joseph Mercy Ann Arbor, Ypsilanti, Michigan, USA.
J Pain Manag. 2019;12(2):141-146.
The purpose of this study was to characterize emergency department (ED) physicians' beliefs and current practices regarding the use of haloperidol for the management of acute and acute on chronic pain.
A survey regarding haloperidol use was distributed by email to attending physicians, resident physicians, nurse practitioners, and physician assistants at emergency medicine departments in the Indiana University Health System and at St Joseph Mercy Ann Arbor.
Of the 129 responses received, the majority (89.1%) of providers had used haloperidol for control of pain in the ED. The most common reason that respondents used haloperidol to treat pain was that they did not want to use an opioid or other agent (91.3%). The majority of providers (73.9%) believed that haloperidol was effective because there is a psychiatric component to pain, while over half of respondents (58.3%) chose haloperidol as they believed it to have analgesic properties. When haloperidol was used as a first line medication, providers felt that it was effective in controlling pain about 69.0% of the time without the need for further medication. The most common presentations for use were for unspecified abdominal pain, headache, and gastroparesis.
ED providers reported using haloperidol most often as a second line treatment to manage both acute and acute on chronic pain. When haloperidol was used as a first line agent, providers claimed that additional medicines were not usually required. Haloperidol may provide an effective alternative to opioids in treatment of acute pain and acute exacerbations of chronic pain in the ED.
本研究的目的是描述急诊科(ED)医生在使用氟哌啶醇治疗急性和慢性疼痛急性发作方面的信念和当前实践。
通过电子邮件向印第安纳大学健康系统和圣约瑟夫慈悲安阿伯市急诊科的主治医生、住院医生、执业护士和医师助理分发了一份关于氟哌啶醇使用情况的调查问卷。
在收到的129份回复中,大多数(89.1%)提供者在急诊科使用过氟哌啶醇来控制疼痛。受访者使用氟哌啶醇治疗疼痛的最常见原因是他们不想使用阿片类药物或其他药物(91.3%)。大多数提供者(73.9%)认为氟哌啶醇有效是因为疼痛存在精神方面的因素,而超过一半的受访者(58.3%)选择氟哌啶醇是因为他们认为它具有镇痛特性。当氟哌啶醇用作一线药物时,提供者认为它在约69.0%的时间里能有效控制疼痛,无需进一步用药。使用氟哌啶醇最常见的情况是不明原因的腹痛、头痛和胃轻瘫。
急诊科提供者报告称,氟哌啶醇最常作为二线治疗药物用于管理急性和慢性疼痛急性发作。当氟哌啶醇用作一线药物时,提供者声称通常不需要额外的药物。在急诊科治疗急性疼痛和慢性疼痛急性加重时,氟哌啶醇可能是阿片类药物的有效替代品。