肾绞痛患者鼻内注射去氨加压素和鼻内注射氯胺酮止痛的比较研究:随机双盲临床试验。

IF 1.9 Q2 EMERGENCY MEDICINE Clinical and Experimental Emergency Medicine Pub Date : 2024-03-01 Epub Date: 2023-07-13 DOI:10.15441/ceem.23.059
Farhad Heydari, Reza Azizkhani, Saeed Majidinejad, Majid Zamani, Aref Norouzian
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引用次数: 0

摘要

目的:尿石症是全球最常见的泌尿系统疾病之一,通常表现为肾绞痛,导致剧烈疼痛,需要镇痛治疗。本研究旨在比较氯胺酮和去氨加压素治疗肾绞痛的疗效:这项双盲、随机临床试验针对 2021 年 6 月至 2022 年 7 月期间转诊至急诊科的肾绞痛患者。患者被随机分配到三组。去氨加压素组患者接受鼻内去氨加压素和静脉注射酮咯酸治疗。氯胺酮组采用鼻内氯胺酮和酮咯酸治疗。对照组接受酮咯酸和鼻内安慰剂治疗。在基线和治疗后 60 分钟评估生命体征;在基线、治疗后 10 分钟、30 分钟和 60 分钟评估疼痛评分:135名患者的平均年龄(标准差)为44.1±11.4岁,82名男性(60.7%)。与对照组(分别为 8.2±1.1、5.1±2.0 和 2.3±2.6)和去氨加压素组(分别为 6.7±1.8、4.2±2.2 和 1.3±1.4)相比,氯胺酮组在 10 分钟、30 分钟和 60 分钟时的平均视觉模拟量表评分(分别为 5.6±1.2、3.0±1.1 和 0.9±0.9)明显较低(PConclusion:氯胺酮对肾绞痛患者的镇痛效果优于去氨加压素,尽管去氨加压素在治疗后的最初几分钟表现出疗效。
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A comparative study of intranasal desmopressin and intranasal ketamine for pain management in renal colic patients: a randomized double-blind clinical trial.

Objective: Urolithiasis is one of the most common urological diseases worldwide, usually presenting as renal colic that leads to severe pain that requires analgesic treatment. This study aimed to compare the efficacy of ketamine and desmopressin in the pain management of renal colic patients.

Methods: This double-blind, randomized clinical trial was conducted on renal colic patients referred to the emergency department from June 2021 to July 2022. Patients were randomly assigned to three groups. In the desmopressin group, patients were treated with intranasal desmopressin and intravenous ketorolac. The ketamine group was treated with intranasal ketamine and ketorolac. The control group received ketorolac and an intranasal placebo. Vital signs were evaluated at baseline and 60 minutes; and pain scores were assessed at baseline, 10, 30, and 60 minutes after treatment.

Results: Enrollment included 135 patients, the mean (standard deviation) age was 44.1±11.4 years, and 82 (60.7%) were men. The mean visual analog scale scores were significantly lower at 10, 30, and 60 minutes in the ketamine group (5.6±1.2, 3.0±1.1, and 0.9±0.9, respectively) compared to the control (8.2±1.1, 5.1±2.0, and 2.3±2.6, respectively) and desmopressin (6.7±1.8, 4.2±2.2, and 1.3±1.4, respectively) groups (P<0.05). Although patients in the desmopressin group had lower mean pain scores than the control group at 10, 30, and 60 minutes, this difference was only significant at 10 minutes after the intervention (P<0.05). No significant differences in vital signs were found at 60 minutes after treatment.

Conclusion: Ketamine showed more favorable analgesic effects in renal colic patients than desmopressin, although desmopressin showed efficacy in the first minutes posttreatment.

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2.80
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10.50%
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