دوشنبه 1 آبان 1396
به پورتال جامع کنگره ها - سمینارها و همایشهای دانشگاه علوم پزشکی تبریز خوش آمدید
   October 23, 2017
   
   
     
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Title Comparison of intranasal ketamine versus intravenous morphine in reducing pain in patients with renal colic, a prospective, randomized, double-blind and placebo-controlled study
Authors Mohammad Reza Farnia, MD, Kermanshah University of Medical Sciences, Emergency Department, Kermanshah, Iran Alireza Jalali, MD, Tehran University of Medical Sciences, Shariati Hospital, Emergency Department, Tehran, Iran Morteza Saeedi, MD, Tehran University of Medical Sciences, Shariati Hospital, Emergency Department, Tehran, Iran Elnaz Vahidi, MD, Tehran University of Medical Sciences, Shariati Hospital, Emergency Department, Tehran, Iran
Abstract Abstract Background Various drugs have been used to relieve pain in patients with renal colic, but none have been successful in alleviating pain thoroughly and rapidly. Ketamine, a popular choice for sedation and analgesic, can be given by different routes such as intranasal. Objective To compare the effectiveness of intranasal (IN) ketamine versus intravenous (IV) morphine in reducing pain in patients with renal colic. Methods A randomized double-blind controlled trial was performed in 53 patients with renal colic recruited from the emergency department (ED). 40 patients were enrolled in the study. Patients in the ketamine group received IN ketamine 1mg/kg and IV placebo while patients in the control group received IV morphine 0.1 mg/kg and IN placebo. IN drugs was administered by mucosal atomization device. Our primary end point was visual analogue scale (VAS) at intervals. Results Before drug administration, the mean ± SD VAS score was 7.40±1.18 in the morphine group (group A) and 8.35±1.30 in the ketamine group (group B) (P-value=0.021). Because baseline VAS score had significant difference between the two groups before drug administration, we conducted ANCOVA (analysis of Covariance) on both sample groups in order to adjust the mentioned difference. At 5 min the mean ±SD VAS score in group (A) and (B) were (6.07±0.47 vs 6.87±0.47; mean difference -0.79 95% confidence interval (CI) -1.48 to -0.10) (P-value=0.025), at 15 and 30 min, the mean ±SD VAS score in group (A) and (B) were (5.24±0.49 vs 5.60±0.49; mean difference -0.36, 95% CI -1.08 to 0.34) and (4.02±0.59 vs 4.17±0.59; mean difference -0.15, 95% CI -1.02 to 0.71) (P-value=0.304 and 0.719) respectively. Eight patients in group A had hypotension and six patients in group B experienced emergence phenomenon, a visual, auditory, proprioceptive or confusional illusion. Conclusions IN ketamine may be effective in decreasing pain in renal colic.
Keywords Ketamine, Morphine, VAS, Intranasal
 
     
     
 
 
     
     
 
 
     
     
 

برنامه اتوماسیون اداری
 
     
     
  بازدیدهای امروز :5330
تعداد کل بازدیدها :4633894