Department of Pharmacy and Therapeutics, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Slot # 571, Little Rock, AR 72205, United States of America.
Department of Pharmacy and Therapeutics, Department of Emergency Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Slot # 571, Little Rock, AR 72205, United States of America.
Am J Emerg Med. 2024 Jan;75:42-45. doi: 10.1016/j.ajem.2023.10.030. Epub 2023 Oct 21.
BACKGROUND/PURPOSE: Gastroparesis is a syndrome of delayed gastric emptying without obstruction. There are high rates of Emergency Department (ED) visits due to gastroparesis, and this chronic disease is difficult to treat which often leads to hospital admissions. This study aimed to evaluate the impact droperidol administration has on opioid therapy, symptom relief, co-administration of antiemetic and prokinetic medications, disposition, cost, and length of stay (LOS) of patients presenting to the ED.
A total of 431 patients were identified and 233 met the inclusion criteria. Droperidol administration reduced the number of patients requiring opioid therapy (108/233 [46%] vs 139/233 [60%], P-value 0.0040), reduced patient-reported pain scales by 4 points, and reduced antiemetic therapy requirement (140/233 [60%] vs 169/233 [73%], P-value 0.0045). No differences were found in terms of ED LOS (Median 6 h [IQR 4-8] vs 5 h [IQR 4-9], P-value 0.3638), hospital LOS (Median 6 h [IQR 4-30 vs 7 h [IQR 4-40], P-value 0.8888), hospital admission rates (67/233 [29%] vs 71/233 [31%], P-value 0.6101), ED cost to the facility (Median $1462 [IQR $1114 - $1986] vs $1481 [IQR $1034 - $2235], P-value 0.0943), or hospital cost (Median $4412 [IQR $2359 - $9826] vs $4672 [IQR $2075 - $9911], P-value 0.3136).
In patients with gastroparesis presenting to the ED, droperidol reduced opioid use, improved pain control, and decreased antiemetic use without any differences in MME per dose, length of stay, hospital admission rate, or cost.
背景/目的：胃轻瘫是一种胃排空延迟而无梗阻的综合征。由于胃轻瘫，急诊科（ED）就诊率很高，而且这种慢性病很难治疗，往往导致住院。本研究旨在评估给予氟哌利多对接受阿片类药物治疗的患者的影响，包括症状缓解、止吐和促动力药物的联合使用、处置、成本以及 ED 就诊患者的住院时间（LOS）。
共纳入 431 例患者，其中 233 例符合纳入标准。给予氟哌利多可减少需要阿片类药物治疗的患者人数（108/233[46%] vs 139/233[60%]，P 值=0.0040），降低患者报告的疼痛评分 4 分，并减少止吐药物的需求（140/233[60%] vs 169/233[73%]，P 值=0.0045）。在 ED LOS（中位数 6 小时[IQR 4-8] vs 5 小时[IQR 4-9]，P 值=0.3638）、住院 LOS（中位数 6 小时[IQR 4-30] vs 7 小时[IQR 4-40]，P 值=0.8888）、住院率（67/233[29%] vs 71/233[31%]，P 值=0.6101）、ED 对医疗机构的费用（中位数 1462 美元[IQR 1114-1986] vs 1481 美元[IQR 1034-2235]，P 值=0.0943）或医院费用（中位数 4412 美元[IQR 2359-9826] vs 4672 美元[IQR 2075-9911]，P 值=0.3136）方面，差异均无统计学意义。
在 ED 就诊的胃轻瘫患者中，氟哌利多可减少阿片类药物的使用，改善疼痛控制，减少止吐药物的使用，且单位剂量的美沙酮等效剂量、LOS、住院率或成本方面无差异。
