Ann Emerg Med:鼻腔内氯胺酮的院前镇痛效果

2020-06-19 MedSci原创 MedSci原创

我们将鼻内氯胺酮与鼻内安慰剂进行比较,将其添加到使用一氧化二氮进行常规护理的情况下,可在30分钟时减轻疼痛。

我们将鼻内氯胺酮与鼻内安慰剂进行比较,将其添加到使用一氧化二氮进行常规护理的情况下,可在30分钟时减轻疼痛。

 

这是一项对院外急性疼痛患者进行的随机双盲研究,他们报告的口头数字评分量表(VNRS)疼痛评分大于或等于5。排除标准是18岁以下,已知的氯胺酮耐受不良,非创伤性胸痛,精神状态改变,怀孕和鼻塞。患者接受常规护理,并随机接受鼻内氯胺酮或鼻内盐溶液,剂量为0.75 mg / kg。主要结局是30分钟时VNRS得分降低大于或等于2的患者比例。次要结果是15分钟时疼痛减轻,患者报告的舒适度,满意度得分,一氧化二氮消耗量以及不良事件的发生率。

 

研究招募了120名受试者。76%的鼻内氯胺酮患者与41%的安慰剂患者报告在30分钟时VNRS降低大于或等于2点(差异35%​​; 95%置信区间17%至51%)。对于氯胺酮和安慰剂,在15分钟时VNRS降低的中位数分别为2.0和1.0,在30分钟时分别为3.0和1.0。据报道,氯胺酮和安慰剂患者在15分钟和30分钟时的舒适度分别提高了75%,57%,61%和46%。氯胺酮组62%(95%的置信区间为49%至73%)和安慰剂组20%(95%的置信区间为12%至32%)的患者出现不良事件,没有患者需要身体或医学干预。

 

总之,该研究结果表明,与鼻内安慰剂相比,鼻内氯胺酮与一氧化二氮相比,具有临床上显着的疼痛减轻和舒适性改善,且不良事件更多。

 

原始出处:

 

Gary Andolfatto, Kelsey Innes, et al., Prehospital Analgesia With Intranasal Ketamine (PAIN-K): A Randomized Double-Blind Trial in Adults. Ann Emerg Med. 2019 Aug;74(2):241-250. doi: 10.1016/j.annemergmed.2019.01.048.

 

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1769985, encodeId=08fc1e6998571, content=<a href='/topic/show?id=51469830949' target=_blank style='color:#2F92EE;'>#院前#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98309, encryptionId=51469830949, topicName=院前)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c5ca38130612, createdName=mhzhuang@stu.e, createdTime=Mon Nov 09 20:19:08 CST 2020, time=2020-11-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1273682, encodeId=273d12e3682d4, content=<a href='/topic/show?id=35136411609' target=_blank style='color:#2F92EE;'>#氯胺酮#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64116, encryptionId=35136411609, topicName=氯胺酮)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=04d6114, createdName=jml2009, createdTime=Sun Jun 21 04:19:08 CST 2020, time=2020-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1355344, encodeId=ca3d1355344f1, content=<a href='/topic/show?id=256a96e9990' target=_blank style='color:#2F92EE;'>#镇痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96799, encryptionId=256a96e9990, topicName=镇痛)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sun Jun 21 04:19:08 CST 2020, time=2020-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1465863, encodeId=734e14658635c, content=<a href='/topic/show?id=736b103508c6' target=_blank style='color:#2F92EE;'>#鼻腔#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103508, encryptionId=736b103508c6, topicName=鼻腔)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=224e6763385, createdName=mnda, createdTime=Sun Jun 21 04:19:08 CST 2020, time=2020-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1610533, encodeId=b412161053305, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Sun Jun 21 04:19:08 CST 2020, time=2020-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1047084, encodeId=8bc4104e084e4, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Fri Jun 19 16:19:08 CST 2020, time=2020-06-19, status=1, ipAttribution=)]
    2020-06-21 jml2009
  3. [GetPortalCommentsPageByObjectIdResponse(id=1769985, encodeId=08fc1e6998571, content=<a href='/topic/show?id=51469830949' target=_blank style='color:#2F92EE;'>#院前#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98309, encryptionId=51469830949, topicName=院前)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c5ca38130612, createdName=mhzhuang@stu.e, createdTime=Mon Nov 09 20:19:08 CST 2020, time=2020-11-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1273682, encodeId=273d12e3682d4, content=<a href='/topic/show?id=35136411609' target=_blank style='color:#2F92EE;'>#氯胺酮#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64116, encryptionId=35136411609, topicName=氯胺酮)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=04d6114, createdName=jml2009, createdTime=Sun Jun 21 04:19:08 CST 2020, time=2020-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1355344, encodeId=ca3d1355344f1, content=<a href='/topic/show?id=256a96e9990' target=_blank style='color:#2F92EE;'>#镇痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96799, encryptionId=256a96e9990, topicName=镇痛)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sun Jun 21 04:19:08 CST 2020, time=2020-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1465863, encodeId=734e14658635c, content=<a href='/topic/show?id=736b103508c6' target=_blank style='color:#2F92EE;'>#鼻腔#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103508, encryptionId=736b103508c6, topicName=鼻腔)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=224e6763385, createdName=mnda, createdTime=Sun Jun 21 04:19:08 CST 2020, time=2020-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1610533, encodeId=b412161053305, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Sun Jun 21 04:19:08 CST 2020, time=2020-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1047084, encodeId=8bc4104e084e4, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Fri Jun 19 16:19:08 CST 2020, time=2020-06-19, status=1, ipAttribution=)]
    2020-06-21 zhaojie88
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    2020-06-21 mnda
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    2020-06-19 CHANGE

    疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的

    0

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