当前位置： SCI文献检索 > ANNALS OF EMERGENCY MEDICINE期刊下所有文献 > Intravenous morphine plus ketorolac is superior to either drug alone for treatment of acute renal colic.

Intravenous morphine plus ketorolac is superior to either drug alone for treatment of acute renal colic.

Abstract：

STUDY OBJECTIVE:To study the efficacy of intravenous ketorolac, morphine, and both drugs in combination in reducing pain in acute renal colic. METHODS:We conducted a prospective, double-blinded, randomized controlled trial in an urban, teaching emergency department. Patients aged 18 to 55 years and with a clinical diagnosis of acute renal colic and a pain rating greater than 5 on a 10-cm visual analogue scale or at least "moderate pain" on a 4-category verbal pain scale were eligible for inclusion. Exclusion criteria were contraindication to nonsteroidal anti-inflammatory drugs or opiates, a history of drug dependence, presence of peritonitis, or analgesics within 6 hours of presentation. Patients received either morphine 5 mg at time zero and 5 mg at 20 minutes, ketorolac 15 mg at time zero and 15 mg at 20 minutes, or a combination of both. Primary outcomes were pain reduction and the need for rescue analgesia at 40 minutes. RESULTS:Of the 555 consecutive patients screened, 158 patients met inclusion criteria and 130 patients were randomized during 6 months. Mean difference in change in pain score (visual analog scale 40 minutes minus visual analog scale 0 minutes) between combination group and morphine group was 1.8 cm (95% confidence interval [CI] -3.3 to -0.1) and, compared to the ketorolac group, was 2.2 cm (95% CI -3.7 to -0.5); P<.003. Patients with combination therapy were less likely to require rescue morphine compared to the morphine group (odds ratio 0.2; 95% CI 0.1 to 0.7; P=.007). CONCLUSION:A combination of morphine and ketorolac offered pain relief superior to either drug alone and was associated with a decreased requirement for rescue analgesia.

journal_name

Ann Emerg Med

journal_title

Annals of emergency medicine

authors

Safdar B,Degutis LC,Landry K,Vedere SR,Moscovitz HC,D'Onofrio G

doi

10.1016/j.annemergmed.2006.03.013

subject

Has Abstract

pub_date

2006-08-01 00:00:00

pages

173-81, 181.e1

issue

2

eissn

0196-0644

issn

1097-6760

journal_volume

48

pub_type

杂志文章,随机对照试验

相关文献

ANNALS OF EMERGENCY MEDICINE文献大全
  • Electrolytes, BUN, creatinine: who's at risk?

    abstract：:Electrolytes, BUN, and creatinine are some of the most frequently ordered laboratory tests. The use of these tests in emergency practice has not been studied critically, and few investigations of their use in other disciplines have been performed. A review of the available literature and an analysis of medical problem...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章,评审

    doi：10.1016/s0196-0644(86)80586-8

    authors： Checchio LM,Como AJ

    更新日期：1986-03-01 00:00:00

  • Two separate unintentional fatalities with the same revolver.

    abstract：:We report 2 deaths and 1 injury that resulted from 2 separate unintentional discharges of the same Ruger Blackhawk revolver. One discharge was a consequence of careless firearm handling combined with a slip during a decocking procedure unique to certain hammer-action firearms. The second discharge occurred when the fi...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1067/mem.2001.112251

    authors： Lee C,Nolte KB

    更新日期：2001-03-01 00:00:00

  • Frequency of inhaled metaproterenol in the treatment of acute asthma exacerbation.

    abstract：:Acute asthma exacerbations are common complaints in patients who present to the emergency department. A prospective, double-blinded study was designed to evaluate how frequency of dosing of an inhaled beta-agonist, metaproterenol (Alupent inhalation solution) would affect patient response, length of stay in the ED, an...

    journal_title：Annals of emergency medicine

    pub_type： 临床试验,杂志文章

    doi：10.1016/s0196-0644(05)82134-1

    authors： Nelson MS,Hofstadter A,Parker J,Hargis C

    更新日期：1990-01-01 00:00:00

  • Continuous intravenous infusion fentanyl for sedation and analgesia of the multiple trauma patient.

    abstract：:Fentanyl is an attractive agent for analgesia in the emergency department. Its use in this setting has been limited to IV bolus administration. We report successful sedation, muscle relaxation, and analgesia of a multiple trauma patient with fentanyl IV bolus and continuous infusion in the ED. ...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/s0196-0644(05)81439-8

    authors： Walsh M,Smith GA,Yount RA,Ferlic FJ,Wieschhaus MF

    更新日期：1991-08-01 00:00:00

  • Opiate antagonist in traumatic shock.

    abstract：:In experimental animal studies, opiate receptor antagonists (such as naloxone) and physiological opiate antagonists (thyrotropin-releasing hormone [TRH] have been used with some success to improve outcome and physiological variables following traumatic shock associated with hypovolemia, spinal cord trauma, and head in...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章,评审

    doi：10.1016/s0196-0644(86)80944-1

    authors： McIntosh TK,Faden AI

    更新日期：1986-12-01 00:00:00

  • Role of iron ions in the genesis of reperfusion injury following successful cardiopulmonary resuscitation: preliminary data and a biochemical hypothesis.

    abstract：:Presented is a rationale for use of a new class of drugs, the iron chelating agents, in advanced cardiac life support (ACLS) to prevent late deaths and brain damage following successful cardiopulmonary resuscitation. The relevant biochemical hypothesis states that free iron ions, liberated from bound intracellular sto...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章,评审

    doi：10.1016/s0196-0644(85)80056-1

    authors： Babbs CF

    更新日期：1985-08-01 00:00:00

  • Clinical safety of lidocaine in patients with cocaine-associated myocardial infarction.

    abstract：STUDY OBJECTIVE:To evaluate the safety of lidocaine in the setting of cocaine-induced myocardial infarction (MI). DESIGN:A retrospective, multicenter study. SETTING:Twenty-nine university, university-affiliated, or community hospitals during a 6-year period (total of 117 cumulative hospital-years). PARTICIPANTS:Pati...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章,多中心研究

    doi：10.1016/s0196-0644(95)70041-2

    authors： Shih RD,Hollander JE,Burstein JL,Nelson LS,Hoffman RS,Quick AM

    更新日期：1995-12-01 00:00:00

  • The Diversity Snowball Effect: The Quest to Increase Diversity in Emergency Medicine: A Case Study of Highland's Emergency Medicine Residency Program.

    abstract：:Blacks, Hispanics/Latinos, American Indians, Pacific Islanders, Alaska Natives, and Native Hawaiians make up 33% of the US population. These same groups are underrepresented in medicine. In 2013, the physician workforce was 4.1% black, 4.4% Hispanic/Latino, 0.4% American Indian or Alaska Native, 11.7% Asian, and 48.9%...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/j.annemergmed.2019.01.039

    authors： Garrick JF,Perez B,Anaebere TC,Craine P,Lyons C,Lee T

    更新日期：2019-06-01 00:00:00

  • An analysis of Part II of the National Board of Medical Examiners Test with regard to questions in emergency medicine.

    abstract：:We conducted a study to determine the number of items and successful response rate to questions specific to emergency medicine on the National Board of Medical Examiners Test, Part II (NBME-II). The 1979 and 1983 NBME-II examinations were reviewed by a subcommittee of the Society of Teachers of Emergency Medicine. Ite...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/s0196-0644(86)80479-6

    authors： Sanders AB,Burdick WP,Stair TO,Witzke D

    更新日期：1986-01-01 00:00:00

  • Quantifying Patient-Physician Communication and Perceptions of Risk During Admissions for Possible Acute Coronary Syndromes.

    abstract：STUDY OBJECTIVE:Disposition decision for patients with possible acute coronary syndrome in the emergency department (ED) is driven primarily by perception of short-term risks. We sought to evaluate communication between patient and physician about these risks by ascertaining the content of discussions surrounding dispo...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/j.annemergmed.2015.01.027

    authors： Newman DH,Ackerman B,Kraushar ML,Lederhandler MH,Masri A,Starikov A,Tsao DT,Meyers HP,Shah KH

    更新日期：2015-07-01 00:00:00

  • Severe metabolic acidosis after acute naproxen sodium ingestion.

    abstract：:Naproxen, a nonsteroidal anti-inflammatory drug (NSAID), is a propionic acid derivative that possesses analgesic and antipyretic properties through inhibition of prostaglandin synthesis. The propionic acids have been considered the least toxic of the NSAIDs, and one, ibuprofen, is currently available as an over-the-co...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/s0196-0644(89)80939-4

    authors： Martinez R,Smith DW,Frankel LR

    更新日期：1989-10-01 00:00:00

  • First-order elimination kinetics following baclofen overdose.

    abstract：:We followed serial plasma baclofen concentrations in a woman who ingested more than 2 g of baclofen in a suicide attempt, the largest ingestion of baclofen reported to date. The plasma clearance of baclofen was characterized by first-order elimination kinetics with a half-life of 8.6 hours. The persistent central nerv...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/s0196-0644(86)80388-2

    authors： Gerkin R,Curry SC,Vance MV,Sankowski PW,Meinhart RD

    更新日期：1986-07-01 00:00:00

  • Reported emergency department avoidance, use, and experiences of transgender persons in Ontario, Canada: results from a respondent-driven sampling survey.

    abstract：STUDY OBJECTIVE:Transgender, transsexual, or transitioned (trans) people have reported avoiding medical care because of negative experiences or fear of such experiences. The extent of trans-specific negative emergency department (ED) experiences, and of ED avoidance, has not been documented. METHODS:The Trans PULSE Pr...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/j.annemergmed.2013.09.027

    authors： Bauer GR,Scheim AI,Deutsch MB,Massarella C

    更新日期：2014-06-01 00:00:00

  • Hyperkalemic ascending paralysis.

    abstract：:Hyperkalemia is a life-threatening electrolyte disturbance. The clinical presentation is most commonly related to its effects on cardiac conductivity and contractility, although weakness and respiratory compromise may occur. We describe what we believe to be the first reported case of life-threatening hyperkalemia pre...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/s0196-0644(98)70107-6

    authors： McCarty M,Jagoda A,Fairweather P

    更新日期：1998-07-01 00:00:00

  • Health care reform and the emergency physician: a personal strategy.

    abstract：:Annals' 25th anniversary is a cause for celebration, but the future imposes a new set of ethical questions and moral dilemmas for emergency physicians. Each physician will need to make personal choices consistent with the courage, judgment, integrity, and dedication of past leaders when dealing with the moral dilemmas...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/s0196-0644(97)70035-0

    authors： Waeckerle JF

    更新日期：1997-12-01 00:00:00

  • Handgun purchase trends, Washington state: differences by age of buyer.

    abstract：STUDY OBJECTIVES:To examine trends in legal handgun purchases from federally licensed dealers and specifically to describe recent changes in age and gender of purchaser and caliber of handguns purchased. METHODS:A cohort study was performed of the adult population of Washington state from 1950 through 1992 using a sta...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/s0196-0644(98)70100-3

    authors： Dowd MD,Grossman DC,Cummings P,Britt J

    更新日期：1998-07-01 00:00:00

  • Ventricular arrhythmias during treatment for acute asthma.

    abstract：:A double-blind, randomized study was performed to determine the occurrence of ventricular arrhythmias in acute asthma patients treated with epinephrine, aminophylline, or both in combination. Sixty patients were studied with Holter monitoring during the 90-minute study period. There was no statistical difference among...

    journal_title：Annals of emergency medicine

    pub_type： 临床试验,杂志文章,随机对照试验

    doi：10.1016/s0196-0644(86)80428-0

    authors： Emerman CL,Crafford WA,Vrobel TR

    更新日期：1986-06-01 00:00:00

  • Decision making in prehospital sudden cardiac arrest.

    abstract：:Many studies of prehospital resuscitation report on selected populations. We examined a series of 445 unselected nontraumatic cardiac arrests. Emergency cardiac care (ECC) was not initiated in 126 (28%). ECC was begun in 319 (78%), but was terminated in 132 (33%). Ninety-four (21%) were admitted to the hospital with p...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/s0196-0644(86)80185-8

    authors： Aprahamian C,Thompson BM,Gruchow HW,Mateer JR,Tucker JF,Stueven HA,Darin JC

    更新日期：1986-04-01 00:00:00

  • Experience with the use of tPA in the treatment of acute myocardial infarction.

    abstract：:Early experience with the use of tissue plasminogen activator (tPA) in acute myocardial infarction is reviewed, including comparisons with other thrombolytic agents, a summary of hemorrhagic complications associated with its use, and the rationale for adjunctive therapeutic strategies. The use of tPA has been associat...

    journal_title：Annals of emergency medicine

    pub_type： 临床试验,杂志文章,评审

    doi：10.1016/s0196-0644(88)80064-7

    authors： Califf RM,Mantell S,Westawski C,Bride W,Honan MB,Bellinger RL,Wall TC

    更新日期：1988-11-01 00:00:00

  • Treatment of acute ischemic stroke.

    abstract：:Acute ischemic stroke is the third leading cause of death in the United States and the leading cause of adult disability. The direct and indirect costs of stroke care exceed $51 billion annually. In 1996, the US Food and Drug Administration approved the first treatment for acute ischemic stroke, intravenous tissue pla...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章,评审

    doi：10.1067/mem.2001.111573

    authors： Lewandowski C,Barsan W

    更新日期：2001-02-01 00:00:00

  • Debriefing in the emergency department after clinical events: a practical guide.

    abstract：:One vital aspect of emergency medicine management is communication after episodes of care to improve future performance through group reflection on the shared experience. This reflective activity in teams is known as debriefing, and despite supportive evidence highlighting its benefits, many practitioners experience b...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/j.annemergmed.2014.10.019

    authors： Kessler DO,Cheng A,Mullan PC

    更新日期：2015-06-01 00:00:00

  • Direct mechanical ventricular assistance during ventricular fibrillation.

    abstract：:A technique of direct mechanical ventricular assistance (DMVA) has been available since 1966. Ventricular assistance is provided by a glass cup lined with a Silastic diaphragm. It is held on the cardiac ventricles by suction. Alternating positive and negative pressure in the space between the cup and the diaphragm pro...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/s0196-0644(83)80247-9

    authors： McCabe JB,Ventriglia WJ,Anstadt GL,Nolan DJ

    更新日期：1983-12-01 00:00:00

  • Effect of visual cues, vital signs, and protocols on triage: a prospective randomized crossover trial.

    abstract：STUDY OBJECTIVES:We sought to compare triage designations derived from in-person and telephone interviews and systematically examine the effect of visual cues, vital signs, and complaint-based protocols on the triage process. METHODS:We conducted a 2-phase, prospective, observational study employing a randomized, cros...

    journal_title：Annals of emergency medicine

    pub_type： 临床试验,杂志文章,随机对照试验

    doi：10.1016/s0196-0644(98)70063-0

    authors： Salk ED,Schriger DL,Hubbell KA,Schwartz BL

    更新日期：1998-12-01 00:00:00

  • Optimizing emergency department front-end operations.

    abstract：:As administrators evaluate potential approaches to improve cost, quality, and throughput efficiencies in the emergency department (ED), "front-end" operations become an important area of focus. Interventions such as immediate bedding, bedside registration, advanced triage (triage-based care) protocols, physician/pract...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章,评审

    doi：10.1016/j.annemergmed.2009.05.021

    authors： Wiler JL,Gentle C,Halfpenny JM,Heins A,Mehrotra A,Mikhail MG,Fite D

    更新日期：2010-02-01 00:00:00

  • Fatal ascending tonic-clonic seizure syndrome.

    abstract：:A fatal case of ascending tonic-clonic seizure (ATCS) syndrome resulted from the inadvertent, unrecognized use of a hyperosmolar ionic contrast agent during myelography. The patient presented with lower-extremity myoclonic jerking, agitation, hyperthermia, rhabdomyolysis, and disseminated intravascular coagulation. Em...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/s0196-0644(98)70045-9

    authors： Dunford J

    更新日期：1998-11-01 00:00:00

  • Homicide and suicide risks associated with firearms in the home: a national case-control study.

    abstract：STUDY OBJECTIVE:I test the hypothesis that having a gun in the home is a risk factor for adults to be killed (homicide) or to commit suicide. METHODS:Two case-control analyses were based on national samples of subjects 18 years of age or older. Homicide and suicide case subjects were drawn from the 1993 National Morta...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1067/mem.2003.187

    authors： Wiebe DJ

    更新日期：2003-06-01 00:00:00

  • Can wrist blood pressure oscillometer be used for triage in an adult emergency department?

    abstract：STUDY OBJECTIVE:We compare the performance of a wrist blood pressure oscillometer with the mercury standard in the triage process of an emergency department (ED) and evaluate the impact of wrist blood pressure measurement on triage decision. METHODS:Blood pressure was successively measured with the standard mercury sp...

    journal_title：Annals of emergency medicine

    pub_type： 临床试验,杂志文章

    doi：10.1016/j.annemergmed.2004.12.007

    authors： Rutschmann OT,Sarasin FP,Simon J,Vermeulen B,Riberdy L,Pechere-Bertschi A

    更新日期：2005-08-01 00:00:00

  • Use of a bilingual medical history questionnaire in the emergency department.

    abstract：STUDY OBJECTIVE:To demonstrate that a complete and rapid clinical history can be obtained using a self-administered, bilingual questionnaire. DESIGN:A post-test experimental design was used to evaluate time spent obtaining the history and information completeness for the two groups. SETTING:Urban county emergency dep...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/s0196-0644(05)80799-1

    authors： Nasr I,Cordero M,Houmes B,Fagan J,Rydman R,Green C

    更新日期：1993-05-01 00:00:00

  • Lisfranc fracture-dislocation: a frequently missed diagnosis in the emergency department.

    abstract：:Lisfranc fracture-dislocations are rare, and their correct diagnosis is important. Misdiagnosis is common and can lead to grave, chronic disability. We present two cases of Lisfranc fracture-dislocation to highlight the mechanisms of injury, clinical presentation, diagnosis, and treatment. Accurate diagnosis by emerge...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/s0196-0644(95)70156-7

    authors： Englanoff G,Anglin D,Hutson HR

    更新日期：1995-08-01 00:00:00

  • Association between prepayment systems and emergency medical services use among patients with acute chest discomfort syndrome. For the Rapid Early Action for Coronary Treatment (REACT) Study.

    abstract：STUDY OBJECTIVE:Cost concerns may inhibit emergency medical services (EMS) use. Novel tax-based and subscription prepayment programs indemnify patients against the cost of EMS treatment and transport. We determine whether the presence of (or enrollment in) prepayment plans increase EMS use among patients with acute che...

    journal_title：Annals of emergency medicine

    pub_type： 临床试验,杂志文章,多中心研究,随机对照试验

    doi：

    authors： Siepmann DB,Mann NC,Hedges JR,Daya MR

    更新日期：2000-06-01 00:00:00