凯托洛拉克剂量上限效应在急诊室的儿科头痛中的作用
Brian Lefchak1, Danielle Morgan2, Mike Finch3
1Department of Pediatric Emergency Medicine (BL, MM), Children's Minnesota, Minneapolis, MN.
概括
在体重至少60公斤的儿科患者中,将最大静脉甲酸剂量降至15毫克有效地控制头痛疼痛,反映了成人研究结果. 这种剂量降低也显示出减少恶心药物使用的趋势.
科学领域:
- 紧急医疗 紧急医疗
- 儿科疼痛管理 儿科疼痛管理
- 药理学 药理学是指药理学的学科.
背景情况:
- 静脉注射凯托洛拉克用于儿科急诊室的急性疼痛.
- 之前在成年人身上进行的研究表明,罗拉克有止痛的天花板效应.
- 对儿科患者的最佳剂量需要进一步调查.
研究的目的:
- 为了确定15毫克静脉注射凯托洛拉克的最大降低剂量是否不低于30毫克用于儿科头痛止痛.
- 为了评估儿科患者的止痛天花板效应.
主要方法:
- 对儿科ED患者 (≥60公斤) 进行了回顾性队列研究,这些患者接受了30毫克或15毫克IV基托洛拉克治疗头痛.
- 主要结局:患者报告的疼痛评分.
- 二次结果:人口统计数据,辅助药物使用和不良影响.
主要成果:
- 在30毫克 (5.6%) 和15毫克 (3.2%) 组之间的救援止痛使用没有显著差异 (p=0.416).
- 与30毫克组 (91.7%) 相比,15毫克组 (83.9%) 的恶心药物使用趋势较小 (p=0.087).
- 15毫克组的平均疼痛评分减少显著增加 (5.1分) 与30毫克组 (3.9分) 相比 (p<0.001).
结论:
- 在体重至少60公斤的患者中,最大15毫克的IV凯托洛拉克剂量是有效的儿科头痛止痛药.
- 这支持儿科患者的止痛天花板效应.
- 进一步的研究可以探索入院率和多剂量疗法.
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