Italian Society of Prehospital Emergency Medicine-SIS 118-Taranto, 74121 Taranto, Italy.
Post Graduate School of Geriatric Medicine, University of Rome "Tor Vergata", 00133 Rome, Italy.
Medicina (Kaunas). 2023 Sep 29;59(10):1746. doi: 10.3390/medicina59101746.
In the Emergency Department (ED), pain is one of the symptoms that are most frequently reported, making it one of the most significant issues for the emergency physician, but it is frequently under-treated. Intravenous (IV), oral (PO), and intramuscular (IM) delivery are the standard methods for administering acute pain relief. Firstly, we compared the safety and efficacy of IN analgesia to other conventional routes of analgesia to assess if IN analgesia may be an alternative for the management of acute pain in ED. Secondly, we analyzed the incidence and severity of adverse events (AEs) and rescue analgesia required. We performed a narrative review-based keywords in Pubmed/Medline, Scopus, EMBASE, the Cochrane Library, and Controlled Trials Register, finding only twenty randomized Clinical trials eligible in the timeline 1992-2022. A total of 2098 patients were analyzed and compared to intravenous analgesia, showing no statistical difference in adverse effects. In addition, intranasal analgesia also has a rapid onset and quick absorption. Fentanyl and ketamine are two intranasal drugs that appear promising and may be taken simply and safely while providing effective pain relief. Intravenous is simple to administer, non-invasive, rapid onset, and quick absorption; it might be a viable choice in a variety of situations to reduce patient suffering or delays in pain management.
在急诊科 (ED)，疼痛是最常报告的症状之一，因此对急诊医生来说是最重要的问题之一，但常常治疗不足。静脉 (IV)、口服 (PO) 和肌肉内 (IM) 给药是缓解急性疼痛的标准方法。首先，我们比较了 IN 镇痛与其他常规镇痛途径的安全性和疗效，以评估 IN 镇痛是否可能成为 ED 急性疼痛管理的替代方法。其次，我们分析了不良事件 (AE) 的发生率和严重程度以及所需的解救性镇痛。我们在 Pubmed/Medline、Scopus、EMBASE、Cochrane 图书馆和对照试验登记处进行了基于叙述性综述的关键字检索，仅在 1992 年至 2022 年的时间范围内找到了二十项符合条件的随机临床试验。总共分析了 2098 名患者，并与静脉内镇痛进行了比较，结果显示不良反应无统计学差异。此外，鼻内镇痛也具有起效迅速和快速吸收的特点。芬太尼和氯胺酮是两种有前途的鼻内药物，它们可能简单、安全地使用，同时提供有效的疼痛缓解。静脉内给药简单、非侵入性、起效迅速、吸收迅速；在减轻患者痛苦或延迟疼痛管理方面，它可能是各种情况下的可行选择。
