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在急诊室治疗急性创伤性疼痛的鼻内与皮下胺:一项随机临床试验
Randa Dhaoui1, Cyrine Kouraichi1, Marwa Toumia2
1Research Laboratory LR12SP18, Monastir University, Monastir, Tunisia.
Annals of emergency medicine
|October 18, 2025
概括
在急性创伤患者中,皮下和鼻内胺没有显示出临床上显著的疼痛缓解差异. 这两种方法都是有效的,但在疼痛管理方面都没有提供优越的优势.
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:
- 急性肌肉骨创伤经常导致急诊室 (ED) 患者中度至重度疼痛.
- 有效的疼痛管理对于患者的舒适性和创伤后的恢复至关重要.
- 胺,一个NMDA受体对手,正在探索其在急性环境中的止痛特性.
研究的目的:
- 为了比较皮下与鼻内胺在急性肌肉骨创伤中的疼痛控制方面的疗效和安全性.
- 为了确定一个给药途径是否比另一种提供临床显著的疼痛减轻.
主要方法:
- 一项随机,双盲,双模拟的前性研究,涉及1194名患有急性肌肉骨创伤中中度至重度疼痛的成年患者.
- 参与者接受了20毫克皮下或20毫克鼻内胺.
- 在多个时间点使用数值评分表 (NRS) 评估疼痛,主要结果在30分钟.
主要成果:
- 在30分钟内,皮下和鼻内胺都显示出统计学上显著的疼痛降低,平均NRS降低分别为-3.70和-4.42.
- 两组之间NRS减少的平均差异 (-0.72) 低于临床意义的1.3 NRS值.
- 在二次结果中没有发现显著差异,除了皮下胺的轻微不良事件发生率更高.
结论:
- 无论是20毫克皮下注射还是20毫克鼻内注射的胺,都没有为患有ED的急性肌肉骨创伤患者的疼痛减轻带来临床重要差异.
- 这两种服用途径都是这种患者群体疼痛管理的可行选择.
- 进一步的研究可能会探索不同的剂量或患者群体.
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