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静脉注射芬太尼与小剂量氯胺酮对服用美沙酮的肢体骨折患者疼痛缓解效果的比较

Comparison of the Effect of Intravenous Fentanyl with Low-Dose Ketamine on Pain Relief in Patients Taking Methadone and Suffering from Limb Fractures.

作者信息

Forghani Mohsen, Nasr Esfahani Mohammad, Vali Marzie

机构信息

Department of Emergency Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

Adv Biomed Res. 2023 Jan 27;12:7. doi: 10.4103/abr.abr_166_21. eCollection 2023.

Abstract

BACKGROUND

Given the significance of pain control in addicted patients and the prominence of not using opioids due to patient's drug dependence, the present study aimed at comparing and evaluating the effect of intravenous fentanyl with low-dose ketamine on pain relief in patients taking methadone and suffering from limb fractures.

MATERIALS AND METHODS

The present double-blind randomized clinical trial was performed on 100 patients taking methadone and suffering from limb fractures. The patients were divided into two groups receiving 1 μg/kg single dose of fentanyl and 0.3 mg/kg single dose of ketamine (low-dose ketamine). Patients' pain scores and the incidence rate of complications were recorded before the intervention, and 15, 30, and 60 min after drug administration and were then compared between the two groups.

RESULTS

The mean pain score of patients 15 min after the intervention was significantly lower in the low-dose ketamine group with a mean of 2.50 ± 1.34 as compared with the fentanyl group with a mean of 7.10 ± 1.43 ( < 0.001). However, the mean pain score was not significantly different between the two groups 30 and 60 min after the intervention ( > 0.05). In addition, the incidence rate of complications was not significantly different between the two groups ( > 0.05).

CONCLUSION

According to the results of this study, low-dose ketamine as compared with fentanyl relieves pain in the mentioned patients with a faster effect and in a shorter time although no difference can be found between the pain scores of the two groups 30 and 60 min after the intervention.

摘要

背景

鉴于疼痛控制在成瘾患者中的重要性以及因患者药物依赖而不使用阿片类药物的突出问题,本研究旨在比较和评估静脉注射低剂量氯胺酮的芬太尼对服用美沙酮且患有肢体骨折患者的疼痛缓解效果。

材料与方法

本双盲随机临床试验对100名服用美沙酮且患有肢体骨折的患者进行。患者被分为两组,分别接受1μg/kg单剂量的芬太尼和0.3mg/kg单剂量的氯胺酮(低剂量氯胺酮)。记录患者在干预前、给药后15、30和60分钟时的疼痛评分及并发症发生率,然后在两组之间进行比较。

结果

干预后15分钟,低剂量氯胺酮组患者的平均疼痛评分为2.50±1.34,显著低于芬太尼组的平均7.10±1.43(<0.001)。然而,干预后30和60分钟时两组的平均疼痛评分无显著差异(>0.05)。此外,两组并发症发生率无显著差异(>0.05)。

结论

根据本研究结果,与芬太尼相比,低剂量氯胺酮能更快、更短时间地缓解上述患者的疼痛,尽管干预后30和60分钟时两组疼痛评分无差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ca9/10012033/fad2c68ed2e3/ABR-12-7-g001.jpg

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