RESUMOS DE EMERGÊNCIA #01: MEDICAÇÕES PARA O MANEJO INICIAL DE DOR

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O departamento de Emergência lida com dor diariamente, variando de dor lombar não-traumática a fraturas por trauma. Escolher droga e dose corretas é de extrema importância para o manejo desses pacientes. Hoje estamos publicando a tradução de um post do Academic Life in Emergency Medicine feito por Dr. Nick Koch e Dr. Sergey Motov (@PainFreeED) do Maimonides Medical Center em Nova York.  Eles nos apresentam um resumo baseado em evidências sobre a seleção e dosagem de medicações para o manejo inicial de dor em pacientes na emergência.

ALiEM Initial Analgesia 1

ALiEM Initial Analgesia 2

ALiEM Initial Analgesia 3

ALiEM Initial Analgesia 4

Ressaltamos que algumas das formulações compostas podem não estar disponíveis no mercado brasileiro.

Baixe o arquivo em PDF aqui!

REFERÊNCIAS

  1. Andolfatto G, Willman E, Joo D, et al. Intranasal ketamine for analgesia in the emergency department: a prospective observational series. Acad Emerg Med. 2013; 20(10): 1050-4. PMID:24127709
  2. Bartfield JM, Flint RD, McErlean M, Broderick J. Nebulized fentanyl for relief of abdominal pain. Acad Emerg Med. 2003; 10(3): 215-8. PMID: 12615585
  3. Beaudoin FL, Lin C, Guan W, Merchant RC. Low-dose ketamine improves pain relief in patients receiving intravenous opioids for acute pain in the emergency department: results of a randomized, double-blind, clinical trial. Acad Emerg Med. 2014; 21(11): 1193-202. PMID:25377395
  4. Borland M, Jacobs I, King B, O’Brien D. A randomized controlled trial comparing intranasal fentanyl to intravenous morphine for managing acute pain in children in the emergency department. Ann Emerg Med. 2007; 49(3): 335-40. PMID: 17067720
  5. Chang AK, Bijur PE, Campbell CM, Murphy MK, Gallagher EJ. Safety and efficacy of rapid titration using 1mg doses of intravenous hydromorphone in emergency department patients with acute severe pain: the “1+1” protocol. Ann Emerg Med. 2009; 54(2): 221-5. PMID:18996618
  6. Curtis KM, Henriques HF, Fanciullo G, Reynolds CM, Suber F. A fentanyl-based pain management protocol provides early analgesia for adult trauma patients. J Trauma. 2007; 63(4): 819-26. PMID: 18090011
  7. Friedman BW, Esses D, Solorzano C, et al. A randomized controlled trial of prochlorperazine versus metoclopramide for treatment of acute migraine. Ann Emerg Med. 2008; 52(4): 399-406. PMID: 18006188
  8. Galinski M, Dolveck F, Combes X, et al. Management of severe acute pain in emergency settings: ketamine reduces morphine consumption. Am J Emerg Med. 2007; 25(4): 385-90. PMID: 17499654
  9. Kostic MA, Gutierrez FJ, Rieg TS, Moore TS, Gendron RT. A prospective, randomized trial of intravenous prochlorperazine versus subcutaneous sumatriptan in acute migraine therapy in the emergency department. Ann Emerg Med. 2010; 56(1): 1-6. PMID: 20045576
  10. Leong LB, Kelly AM. Are butyrophenones effective for the treatment of primary headache in the emergency department? CJEM. 2011; 13(2): 96-104. PMID: 21435315
  11. Lvovschi V, Aubrun F, Bonnet P, et al. Intravenous morphine titration to treat severe pain in the ED. Am J Emerg Med. 2008; 26(6): 676-82. PMID: 18606320
  12. Miller JP, Schauer SG, Ganem VJ, Bebarta VS. Low-dose ketamine vs morphine for acute pain in the ED: a randomized controlled trial. Am J Emerg Med. 2015; 33(3): 402-8. PMID: 25624076
  13. Motov S, Rockoff B, Cohen V, et al. Intravenous Subdissociative-Dose Ketamine Versus Morphine for Analgesia in the Emergency Department: A Randomized Controlled Trial. Ann Emerg Med. 2015; 66(3): 222-229.e1. PMID: 25817884
  14. Patanwala AE, Keim SM, Erstad BL. Intravenous opioids for severe acute pain in the emergency department. Ann Pharmacother. 2010; 44(11): 1800-9. PMID: 20978218
  15. Thomas SH. Emergency department analgesia: An evidence based guide. Cambridge University Press, 2008.
  16. Yeaman F, Meek R, Egerton-Warburton D, Rosengarten P, Graudins A. Sub-dissociative-dose intranasal ketamine for moderate to severe pain in adult emergency department patients.Emerg Med Australas. 2014; 26(3): 237-42. PMID: 24712757

Original por Academic Life in Emergency Medicine
Traduzido por Miguel Ricchetti
Revisado por Henrique Puls

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