Comparison of IV dexketoprofen trometamol, fentanyl, and paracetamol in the treatment of renal colic in the ED: A randomized controlled trial

Al, Behçet; Sunar, Mehmet Mustafa; Zengin, Suat; Sabak, Mustafa; Boğan, Mustafa; Can, Basri; Kül, Seval; Oktay, Mehmet Murat; Eren, Şevki Hakan

doi:10.1016/j.ajem.2017.09.019

Cited by 17 publications

(24 citation statements)

References 26 publications

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“…Результаты рандомизированного контролируемого исследования, проведенного в 2018 г., показали высокую эффективность декскетопрофена трометамола, которая превосходит анальгетический эффект парацетамола и фентанила, при его применении для обезболивания почечной колики не требовалось назначения дополнительных лекарственных средств [21].…”

Section: информация об авторахunclassified

Pain syndrome in medical practice therapeutic potential of dexketoprofen administration

Ketova

Barysheva

2019

Med. sov.

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Section: информация об авторахunclassified

Pain syndrome in medical practice therapeutic potential of dexketoprofen administration

Ketova

Barysheva

2019

Med. sov.

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“…Also, even the assessment of pain using a VAS for an acutely painful condition can lead to difficulties in comparing treatments if the pain is measured at different intervals. Table illustrates the timing of pain assessments for 10 recently published trials on acute ureteric colic . Although all studies used a VAS, it can be seen that making valid comparisons between the studies regarding the ‘best’ treatment is very difficult.…”

Section: The Current Approach To Choosing Outcome Measuresmentioning

confidence: 99%

Review article: A primer for clinical researchers in the emergency department: Part VI. Measuring what matters: Core outcome sets in emergency medicine research

Craig

Graudins

Dalziel

et al. 2018

Emerg Medicine Australasia

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In this series we address important topics for clinicians who participate in research as part of their work in the ED. The overarching goal of clinical research is to improve care and determine which treatment is best. Yet, defining and measuring outcomes - what is 'best' - can be one of the most difficult steps in the design of a study, in particular when answers to research questions cannot be captured in simple binary results. This article addresses how to choose outcome measures and highlights the increasingly important concept of core outcome sets.

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“…However, there is a considerable body of literature demonstrating non-inferiority in non-opiate medication administration as compared to opiates for many conditions commonly encountered in the prehospital setting including renal colic, long bone fracture, and other minor traumatic limb injuries. [12][13][14][15] While most clinicians are in agreement that prehospital providers should treat pain, there remains equipoise as to how to guide prehospital pain management. Providers must attempt to consolidate information pertaining to patients' self-reported levels of pain, clinical characteristics, and the possible adverse effects of available analgesics, and then make an expeditious decision about which medication to administer.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Paramedic Pain Management Practice with Introduction of a Non-opiate Treatment Protocol

O’Connor

Dugas

Brady

et al. 2020

WestJEM

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Introduction: There is concern about the initiation of opiates in healthcare settings due to the risk of future misuse. Although opiate medications have historically been at the core of prehospital pain management, several states are introducing non-opiate alternatives to prehospital care. Prior studies suggest that non-opiate analgesics are non-inferior to opiates for many acute complaints, yet there is little literature describing practice patterns of pain management in prehospital care. Our goal was to describe the practice patterns and attitudes of paramedics toward pain management after the introduction of non-opiates to a statewide protocol. Methods: This study was two-armed. The first arm employed a pre/post retrospective chart review model examining medication administrations reported to the Massachusetts Ambulance Trip Information System between January 1, 2017-December 31, 2018. We abstracted instances of opiate and non-opiate utilizations along with patients' clinical course. The second arm consisted of a survey administered to paramedics one year after implementation of non-opiates in the state protocol, which used binary questions and Likert scales to describe beliefs pertaining to prehospital analgesia. Results: Pain medications were administered in 1.6% of emergency medical services incidents in 2017 and 1.7% of incidents in 2018. The rate of opiate analgesic use was reduced by 9.4% in 2018 compared to 2017 (90.6% vs 100.0%). The absolute reduction in opiate use in 2018 was 3.6%. Women were less likely (odds ratio [OR] = 0.78, 95% confidence interval [CI], 0.69-0.89) and trauma patients were more likely to receive opiates (OR = 2.36, CI, 1.96-2.84). Mean transport times were longer in opiate administration incidents (36.97 vs 29.35 minutes, t = 17.34, p<0.0001). We surveyed 100 paramedics (mean age 41.98, 84% male). Compositely, 85% of paramedics planned to use nonopiates and 35% reported having done so. Participants planning to use non-opiates were younger and less experienced. Participants indicated that concern about adverse effects, efficacy, and time to effect impacted their practice patterns. Conclusion: The introduction of non-opiate pain medication to state protocols led to reduced opiate administration. Men and trauma patients were more likely to receive opiates. Paramedics reported enthusiasm for non-opiate medications. Beliefs about non-opioid analgesics pertaining to adverse effects, onset time, and efficacy may influence their utilization. [

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Comparison of IV dexketoprofen trometamol, fentanyl, and paracetamol in the treatment of renal colic in the ED: A randomized controlled trial

Cited by 17 publications

References 26 publications

Pain syndrome in medical practice therapeutic potential of dexketoprofen administration

Pain syndrome in medical practice therapeutic potential of dexketoprofen administration

Review article: A primer for clinical researchers in the emergency department: Part VI. Measuring what matters: Core outcome sets in emergency medicine research

Paramedic Pain Management Practice with Introduction of a Non-opiate Treatment Protocol

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