-比较morphine与Pethine在急诊疑似肾性绞痛的止痛疗效....doc

A comparison of the efficacy and safety of morphine and pethidine as analgesia for suspected renal colic in the emergency setting Alan OConnor, Stephan A Schug, Hester Cardwell Abstract Objectives -比較morphine與Pethine在急診疑似腎性絞痛的止痛療效、病患滿意度及併發症。 Methods - 雙盲隨機控制試驗 Results – 所有參數都沒有分別 Conclusion -針對腎性絞痛於使用鴉片類止痛劑時，作者建議嗎啡較適合 。 (T Accid Emerg Med 2000;17:261-264) Keywords: renal colic; pethidine; morphine 腎性絞痛內科常見，佔工業化國家人口1~5 %，白人男人20 %，女人5~10 %。典型是因輸尿管結石阻塞，是人們經歷過最嚴重的疼痛之一。 急診的主要目標 - 疼痛緩解直到自動掉出或手術治療開始。治療使用藥物包括解痙劑、非類固醇類抗發炎藥物﹑鴉片類。 鴉片類 - 援救用藥。澳洲鴉片類是最常被使用於腎性絞痛的止痛藥 - Pethidine 使用最廣泛，且非類固醇類抗發炎藥物並不能減低其使用需求). 比較Efficacy（成效）, Safety（安全性）, and patient satisfaction（病患舒適性） Methods 奧克蘭醫院急診部、市立三級教學醫院，560床 PATIENTS 18到65歲並排除過敏、濫用、肝腎疾病???? 影像學及血液學之前，但於尿液分析之後；單側腹痛及血尿 解釋並獲得口頭同意；職業道德委員會證實；結論時簽名同意 STUDY PROCEDURE A trial syringe was allocated to each patient using a computer generated randomisation list ( 電腦隨機表單 ).Each syringe contained 10 ml of solution, either 10 mg of morphine or 100 mg of pethidine ( 注射器中含10 ml溶液，10 mg嗎啡或100 mg pethidine ). The patient was asked to plot their pain score on a visual analogue scale (VAS). The VAS was a 100 mm, unnumbered horizontal scale bounded by the descriptors no pain and worst pain imaginable. Each patient was then given I0 mg of intravenous metoclopramide as antiemetic prophylaxis, before administration of analgesia ( Gastro-Timelets, primperan-止吐 ). Analgesia was titrated as per the trial sheet (fig I) according to the current hospital protocol for opioid analgesia, which was adapted for use in this trial. The patient’s pain score was recorded 30 minutes after the start of the trial( 試驗起使三十分鐘後記錄疼痛分數 ). The trial finished when either the patient had a pain score of less than 3 for 30 mmules after the last analgesic dose, or the 10 ml solution in the syringe was used up.（終止—小於三分或10 ml用完 ） On completion of the trial protocol, the patients final pain score was recorded, and their satisfaction score was charted using a VAS.(最後的疼痛分數及滿意度紀錄) The p