内部心房発動阻害時のショックによる不快感に対するブターファノールタルトレートの効果
C Timmermans1, L M Rodriguez, G M Ayers
1Department of Cardiology, Academic Hospital Maastricht, The Netherlands. C.Timmermans@cardio.azm.nl
Circulation
|April 13, 1999
まとめ
鼻内注入のブートルファノール (オピオイド) は,心房不振時の痛みを効果的に軽減しました. この鎮痛剤は,恐怖を高めることなく患者の快適さを向上させ,手術をより受け入れやすくしました.
科学分野:
- 心臓病学 心臓病学
- アネステシオロジー アネステシオロジー
- 薬理学 薬理学とは
背景:
- 動脈細動のための心内動脈動阻害は,患者の大きな不快感を引き起こす可能性があります.
- 迅速に作用する鎮痛剤と抗不安剤が必要であり,この処置に対する患者の耐性を向上させる必要がある.
研究 の 目的:
- 内心心房動時の鎮痛剤および抗不安剤としての鼻内ブートルファノールの有効性を評価する.
- ステップアップデフィブリレーションプロトコル中に痛みと恐怖の知覚に対するブートルファノールの影響を評価する.
主な方法:
- 双盲,プラセボ対照試験で,内心動脈動を患った47人の患者が参加した.
- 患者は鼻内ブートルファノールまたはプラセボを投与され,必要に応じて追加投与が行われました.
- 痛みと恐怖は,マギル疼痛アンケート (PRI) と視覚アナログスケール (VAS) を使用して,各ショック後に評価されました.
主要な成果:
- 鼻内ブートルファノールは,除細動プロトコルII段階の疼痛評価指数 (PRI) の合計,感覚,評価スコアを著しく低下させた.
- ブートルファノールを投与された患者は,ステージIIへの移行時にプラセボと比較して痛みのスコア (VAS-P,PRI-T,PRI-S,PRI-E) を著しく低下させた.
- ブートルファノールは,処置中の恐怖 (VAS-F) レベルに有意な影響を及ぼさなかった.
結論:
- 鼻内ブートルファノールは,内部心房機能失動に関連した痛みを効果的に軽減します.
- 鎮痛効果は,主に感覚的および評価的疼痛成分を標的とし,感情的成分は影響を受けなかった.
- この研究では,鼻内ブートルファノールが心房不振時の患者の快適性を向上させるための有効な選択肢であり,PRIはVASよりもより正確な痛みの評価ツールであることを示唆しています.
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