RANDOMIZED DOUBLE-BLIND COMPARISON OF THE ANALGESIC EFFICACY OF INTRAMUSCULAR KETOROLAC AND ORAL INDOMETHACIN IN THE TREATMENT OF ACUTE GOUTY-ARTHRITIS

被引:75
作者
SHRESTHA, M [1 ]
MORGAN, DL [1 ]
MOREDEN, JM [1 ]
SINGH, R [1 ]
NELSON, M [1 ]
HAYES, JE [1 ]
机构
[1] UNIV TEXAS,SW MED SCH,DIV EMERGENCY MED,DALLAS,TX 75235
关键词
D O I
10.1016/S0196-0644(95)70037-4
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Study objective: To compare the analgesic effect of IM ketorolac tromethamine with that of oral indomethacin in the treatment of acute gouty arthritis. Design: Prospective, randomized, double-blind, controlled, parallel group clinical trial. Setting: Two urban emergency departments. Participants: Twenty consecutive patients who presented to the ED with acute gout. Interventions: Each patient was randomly assigned to receive in the ED (1) 60 mg of IM ketorolac and oral placebo or (2) 50 mg of oral indomethacin and IM placebo. The patients rated the intensity of their pain on a Wong-Baker pain scale (which runs from 0 to 5) before treatment and 30, 60, 90, and 120 minutes after treatment. All the patients were discharged with instructions to take oral indomethacin and to complete pain score cards at home at 6, 12, and 24 hours. Results: The 10 patients in each group were similar with regard to age, sex, race, and initial mean pain score. After 2 hours, the mean pain scores (+/-SD) for the ketorolac group had decreased from 4.5+/-.71 to 1.4+/-1.43 (P<.05), and the mean score for the indomethacin group had decreased from 4.4+/-.70 to 1.5+/-1.18 (P<.05). The difference between the two groups was not significant. At 6 hours, there was some pain rebound in the ketorolac group. Conclusion: IM ketorolac and oral indomethacin are similar in the relief of the pain of acute gouty arthritis in the ED.
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页码:682 / 686
页数:5
相关论文
共 21 条
[1]  
Wallace, Singer, Therapy in gout, Rheum Dis Clin North Am, 14, pp. 441-457, (1988)
[2]  
Diamond, Control of crystal induced arthropathies, Rheum Dis Clin North Am, 15, pp. 557-567, (1989)
[3]  
Bellamy, Downie, Buchanan, Observations on spontaneous improvement in patients with podagra: Implications for therapeutic trials of non-steroidal-anti-inflammatory drugs, Br J Clin Pharmacol, 24, pp. 33-36, (1987)
[4]  
Arnold, Preston, Buchanan, Comparison of the natural history of untreated gouty arthritis vs acute gouty arthritis treated with non-steroidal-anti-inflammatory drugs (letter), Br J Clin Pharmacol, 26, pp. 488-489, (1988)
[5]  
Bellamy, Gilbert, Brooks, Et al., A survey of current prescribing practices of antiinflamatory and urate lowering drugs in gouty arthritis in the province of Ontario, J Rheumatol, 15, pp. 1841-1847, (1988)
[6]  
Ruotsi, Vainio, Treatment of acute gouty arthritis with proquazone and indomethacin A comparative double-blind trial, Scandinavian Journal of Rheumatology, 21, Supplement, pp. 15-17, (1978)
[7]  
Altman, Stephen, Levin, Et al., Ketoprofen versus indomethacin in patients with acute gouty arthritis: A multicenter, double blind, comparative study, J Rheumatol, 15, pp. 1422-1426, (1988)
[8]  
Shrestha, Chiu, Martin, Et al., Treatment of acute gouty arthritis with intramuscular ketorolac romethamine, Am J Emerg Med, 12, pp. 454-455, (1994)
[9]  
Wallace, Robinson, Masi, Et al., Preliminary criteria for the classification of the acute arthritis of primary gout, Arthritis Rheum, 20, pp. 895-900, (1977)
[10]  
Whaley, Wong, Nursing Care of Infants and Children, pp. 1146-1151, (1991)