Koenig K L, Hodgson L, Kozak R, Jordan K, Sexton T R, Leiken A M
Highland Hospital Emergency Department, Oakland, CA 94602, USA.
Acad Emerg Med. 1994 Nov-Dec;1(6):544-9. doi: 10.1111/j.1553-2712.1994.tb02550.x.
To compare the pain relief, sedation, and common side effect profiles of ketorolac tromethamine and meperidine for the management of acute pain in the emergency department (ED).
A prospective, double-blind, randomized clinical trial was conducted over a 12-month period using consecutive adult patients presenting to a university teaching hospital ED (annual census: 32,000), who required IM analgesia for acute pain. Adult patients with acute pain of various etiologies were randomly assigned to receive a single fixed IM dose of ketorolac (60 mg) or meperidine (100 mg).
Ninety-three patients were enrolled in the study; 46 were randomized to meperidine and 47 to ketorolac. Using a visual analog scale, there was no difference in pain relief between the ketorolac and meperidine groups even after adjusting for baseline pain level. Ketorolac caused significantly (p < 0.005) less sedation than did meperidine at one hour. Rescue analgesia was required for seven of the 46 (15.2%) patients receiving meperidine and five of the 47 (10.6%) patients receiving ketorolac (p = NS). Seventeen of 45 (38%) patients receiving meperidine experienced side effects compared with eight of the 47 (17%) patients receiving ketorolac (p = 0.0452).
When used to treat patients who had acute pain states, 60 mg of IM ketorolac produced analgesia similar to that produced by 100 mg of IM meperidine; however, the ketorolac produced fewer subjective side effects and less sedation than did the meperidine.
比较酮咯酸氨丁三醇和哌替啶在急诊科（ED）治疗急性疼痛时的止痛效果、镇静作用及常见副作用。
进行了一项为期12个月的前瞻性、双盲、随机临床试验，纳入连续就诊于某大学教学医院急诊科（年就诊人数：32000）且因急性疼痛需要肌内注射镇痛的成年患者。将各种病因引起急性疼痛的成年患者随机分配接受单次固定肌内注射剂量的酮咯酸（60毫克）或哌替啶（100毫克）。
93名患者纳入研究；46名随机分配至哌替啶组，47名至酮咯酸组。使用视觉模拟量表，即使在调整基线疼痛水平后，酮咯酸组和哌替啶组在止痛效果上也没有差异。在1小时时，酮咯酸引起的镇静作用明显（p < 0.005）低于哌替啶。接受哌替啶的46名患者中有7名（15.2%）需要追加镇痛，接受酮咯酸的47名患者中有5名（10.6%）需要追加镇痛（p = 无显著差异）。接受哌替啶的45名患者中有17名（38%）出现副作用，而接受酮咯酸的47名患者中有8名（17%）出现副作用（p = 0.0452）。
用于治疗急性疼痛状态的患者时，60毫克肌内注射酮咯酸产生的镇痛效果与100毫克肌内注射哌替啶相似；然而，酮咯酸产生的主观副作用比哌替啶少，镇静作用也比哌替啶轻。
