吗啡加安慰剂与吗啡加乙氨基治疗急性疼痛在急诊室:一个随机临床试验
Guillaume Cattin1, Damien Viglino2, Julien Segard3
1Service des Urgences, Nantes Université, Centre Hospitalier Universitaire Nantes, Nantes, France.
JAMA network open
|February 24, 2026
概括
静脉注射的乙氨基与吗啡相结合并没有证明在急诊室的急性疼痛缓解方面不低于单独的吗啡. 然而,乙氨基显示出潜在的益处,建议其用于量身定制的疼痛管理策略.
科学领域:
- 紧急医疗 紧急医疗
- 药理学 药理学是指药理学的学科.
- 临床试验 临床试验
背景情况:
- 静脉注射 (IV) 乙氨基经常用于急诊室 (ED) 治疗急性疼痛的多模式止痛.
- 它与标位吗啡相结合时的附加效益仍然不确定.
- 在ED中优化急性疼痛管理对于患者的治疗结果至关重要.
研究的目的:
- 为了确定IV吗啡加乙氨基是否不劣于IV吗啡加安慰剂来缓解ED中急性疼痛的成年人的疼痛.
- 评估乙氨基作为吗啡的辅助剂在疼痛管理中的有效性.
主要方法:
- 一个多中心,双盲,随机,安慰剂控制的非劣等性试验.
- 患有严重急性疼痛的成年人 (数值评分表[NRS]得分≥5) 接受了基于体重的定位IV吗啡.
- 随机分配患者接受IV乙氨基 (1g) 或与之匹配的安慰剂.
主要成果:
- 该研究包括430名患者;在修改治疗意图 (mITT) 群体中分析了424名患者.
- 在创伤性和非创伤性疼痛子组中,减轻疼痛有利于乙氨基组.
- 然而,这些差异没有达到1点的预规定的非劣势差额.
结论:
- 与IV吗啡加氨酸相比,IV吗啡加安慰剂在ED急性疼痛缓解方面没有满足非劣质标准.
- 乙氨基可能在个性化ED急性疼痛治疗中作为吗啡的辅助剂提供潜在的益处.
- 进一步的研究可能会探索在急性疼痛管理中对乙氨基的最佳剂量和患者选择.
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