应急诊所创伤患者使用吸入甲氧化进行疼痛自我管理:一项前性,干预性,单中心研究
Daniel Aiham Ghazali1,2,3, Donia Bouzid3,4, Alix Frachon4
1Emergency Department and Emergency Medical Services, Amiens University Medical Center, 1 Rond-Point du Professeur Christian Cabrol, 80000 Amiens, France.
概括
自主使用的甲氧化与世界卫生组织 (WHO) 的止痛梯相结合,有效地减少了急诊室的创伤疼痛. 这种方法导致疼痛得分的更大降低,并且在出院时疼痛的患者更少.
科学领域:
- 紧急医疗 紧急医疗
- 疼痛管理 疼痛管理
- 药理学 药理学是指药理学的学科.
背景情况:
- 由于COVID-19大流行,急诊室 (ED) 过度拥挤,影响了患者的护理.
- 在前ED快速通道区域的低急性非COVID-19患者需要有效的疼痛管理.
- 标准的止痛梯可能需要辅助疗法以获得最佳的疼痛缓解.
研究的目的:
- 为了评估自给自取,吸入,低剂量甲氧的疗效,作为世卫组织治疗创伤疼痛的止痛药阶梯的辅助剂.
- 评估梅托克西佛在ED前环境中的疼痛缓解的影响.
- 为了比较标准护理和甲氧化干预之间的疼痛评分和排泄疼痛水平.
主要方法:
- 法国巴黎比查特大学医学中心的一项前性,干预性,单中心研究.
- 两个组:对照组 (世卫组织标准的止痛药阶梯) 和干预组 (WHO阶梯附加的甲氧化).
- 主要终点:数值疼痛评分尺度 (NPRS) 在不同时间点的得分;次要:与世卫组织梯子 (科恩的卡帕) 达成一致.
主要成果:
- 在NPRS和WHO两组的止痛药梯之间达成高度一致 (科恩的卡帕:0.74对照,0.70干预).
- 在两组中,从抵达到出院的NPRS得分显著下降 (p < 0.001).
- 在甲氧化组中,分拣和出院之间的NPRS减少更大 (p < 0.001);在出院时疼痛的患者显著减少 (p = 0.001).
结论:
- 当与世卫组织止痛药阶梯一起使用时,自给药的甲氧氨酸可以改善ED的疼痛管理.
- 在ED前的环境中,甲氧化为轻度至中度创伤疼痛提供了有效的辅助疗法.
- 这一策略可以减少患者报告的疼痛,并改善过度拥挤的急诊室的结果.
相关概念视频
01:20Inhalational Anesthetics: Overview
357
Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
357
01:15Opioid Analgesics: Synthetic and Semisynthetic Opioids
347
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
347
01:24Parenteral Anesthetics: Overview
160
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
160
01:25Analgesia and Pain Management
668
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
668
01:29Local Anesthetics: Clinical Application as Epidural Anesthesia
460
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
460