Pediatric Neurology ( IF 3.8 ) Pub Date : 2020-12-16 , DOI: 10.1016/j.pediatrneurol.2020.12.004 Nirupama Kannikeswaran 1 , Lavina Desai 2 , Ahmad Farooqi 3 , Lalitha Sivaswamy 4
Background
A combination of parenteral medications (often referred to as standard combination therapy) is frequently used in the treatment of acute migraine in the pediatric emergency department (PED). The primary aim of this study was to evaluate the two-hour, 24-hour, and seven-day impact of one such regimen on pain in children who present to the PED. Standard combination therapy for purposes of our study is defined as a bolus of intravenous saline, and a combination of intravenous ketorolac, prochlorperazine, and diphenhydramine.
Methods
This prospective observational study included 120 children between the ages seven and 18 years who presented to the PED with migraine, whose parents could read and understand the consent form in English, and who were treated with standard combination therapy. The primary outcome measure for this study was the change in severity of pain as noted by the child using the Faces Pain Scale-Revised. We analyzed normally distributed continuous variables by mean and standard deviation, whereas non-normally distributed continuous variables are reported by median and interquartile range.
Results
Nonparametric Friedman testing on the entire cohort (n = 120) noted that there was a statistically significant change in the Faces pain scale from before administration of standard combination therapy to the two-hour, 24-hour, and one-week time point with a reduction in pain score of 87.5%, 100%, and 50%, respectively, at the three time points.
Conclusions
This study noted moderate relief of pain after administration of standard combination therapy, which persisted at one-week after administration.
中文翻译:
小儿偏头痛标准联合治疗的有效性
背景
胃肠外药物的组合(通常称为标准组合疗法)经常用于治疗儿科急诊科 (PED) 中的急性偏头痛。本研究的主要目的是评估一种此类方案对就诊于 PED 的儿童疼痛的 2 小时、24 小时和 7 天影响。出于我们研究的目的,标准联合治疗被定义为静脉推注生理盐水,以及静脉注射酮咯酸、丙氯拉嗪和苯海拉明的组合。
方法
这项前瞻性观察性研究包括 120 名 7 至 18 岁的儿童,他们因偏头痛就诊于 PED,其父母可以阅读和理解英文的同意书,并接受标准联合治疗。本研究的主要结果测量是儿童使用修订版面部疼痛量表记录的疼痛严重程度的变化。我们通过平均值和标准差分析了正态分布的连续变量,而非正态分布的连续变量通过中位数和四分位数范围报告。
结果
对整个队列 (n = 120) 进行的非参数弗里德曼测试指出,从标准联合治疗前到 2 小时、24 小时和 1 周时间点,Faces 疼痛量表存在统计学显着变化在三个时间点,疼痛评分分别降低了 87.5%、100% 和 50%。
结论
该研究指出,在施用标准联合疗法后,疼痛会适度缓解,并在施用后持续一周。