In 2016, in a lead poisoning outbreak in Iran, physicians reported thousands of opium users who presented to emergency departments (EDs) with intractable severe abdominal pain which did not respond to any narcotic medication. During the same period of time, we investigated the efficacy of intravenous calcium gluconate in alleviating lead-induced abdominal pain. In a single-center, single blinded, randomized controlled trial, a convenient sample of adult opium-addicted patients who presented to an academic ED with abdominal pain and had an initial diagnosis of lead poisoning were included and randomly subjected to two treatment groups receiving conventional treatment (morphine 0.1 mg/kg + normal saline; group 1) and conventional treatment plus 1 g of intravenous calcium gluconate (group 2) to alleviate their abdominal pain. The visual analogue scale (VAS) was determined by each patient (0 to 100 mm) before treatment, and 15, 30, and 60 min after intervention. A total of 50 patients (25 in each group) were enrolled. Blood lead levels, VAS scores before treatment, and mean administered dose of morphine were similar between the two groups. After treatment, mean VAS score dropped to 64.7± 10.4 vs. 67.1± 10.9 at 15 min (P = 0.437), 64.6± 10.9 vs. 58.0 ± 11.2 at 30 min (P = 0.041), and 63.8± 10.7 vs. 53.6± 10.9 at 60 min (P = 0.002) in groups 1 and 2, respectively. Intravenous calcium gluconate administration along with morphine can improve abdominal pain in lead poisoning due to the ingestion of lead-contaminated opium. Further interventional studies are recommended to see if response to calcium salts in suspected lead-induced abdominal pain can rule in lead toxicity. IRCT20171009036661N2. Registered 27 May 2018 - Retrospectively registered,

中文翻译：

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静脉注射葡萄糖酸钙可缓解铅引起的腹痛，一项随机临床试验


2016 年，在伊朗爆发的铅中毒事件中，医生报告称，数千名鸦片吸食者因顽固性严重腹痛而到急诊科 (ED) 就诊，且对任何麻醉药物均无反应。同一时期，我们研究了静脉注射葡萄糖酸钙在缓解铅引起的腹痛方面的功效。在一项单中心、单盲、随机对照试验中，纳入了成年鸦片成瘾患者的方便样本，这些患者因腹痛而到学术急诊科就诊，并初步诊断为铅中毒，并随机分为两个接受常规治疗的治疗组治疗（吗啡0.1mg/kg+生理盐水；第1组）和常规治疗加1g静脉注射葡萄糖酸钙（第2组）缓解腹痛。每位患者在治疗前以及干预后15、30和60分钟测定视觉模拟评分（VAS）（0至100毫米）。共有 50 名患者（每组 25 名）入组。两组之间的血铅水平、治疗前 VAS 评分以及吗啡平均给药剂量相似。治疗后，15 分钟时平均 VAS 评分降至 64.7± 10.4 对比 67.1± 10.9 (P = 0.437)，30 分钟时分别降至 64.6± 10.9 对比 58.0 ± 11.2 (P = 0.041)，以及 63.8± 10.7 对比 53.6±第 1 组和第 2 组在 60 分钟时分别为 10.9 (P = 0.002)。静脉注射葡萄糖酸钙和吗啡可以改善因摄入受铅污染的鸦片而导致的铅中毒腹痛。建议进行进一步的介入研究，看看疑似铅引起的腹痛对钙盐的反应是否可以决定铅中毒。 IRCT20171009036661N2。 2018 年 5 月 27 日注册 - 追溯注册，