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首页> 外文期刊>European journal of clinical pharmacology >Treatment of acute renal colic in a French emergency department: a comparison of simulated cases and real cases in acute pain assessment and management.
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Treatment of acute renal colic in a French emergency department: a comparison of simulated cases and real cases in acute pain assessment and management.

机译：法国急诊科对急性肾绞痛的治疗：急性疼痛评估和管理中模拟病例与实际病例的比较。

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OBJECTIVE: Use of analgesic drugs in acute renal colic varies widely in different countries. In order to assess the prescribing patterns in acute renal colic in French emergency departments (EDs), the present study compared intentions of prescription, real prescription and evidence-based data in a sample of emergency practitioners. METHODS: A sample of 51 emergency practitioners (27 medical doctors and 24 residents) randomly selected in nine EDs in the southwest of France participated in this observational study. In a first step (January 2000), participants were asked about a simulated case of acute renal colic. In a second step, real prescriptions for the same indication were retrospectively identified and collected among hospital medical databases during a period of 6 months (July-December 1999). RESULTS: In simulated cases, non-steroidal anti-inflammatory drugs (NSAIDs) were prescribed in 100% of cases, in addition to propacetamol (70%), antispasmodic drugs (53%) and opiate analgesics (100%). Daily dose of these drugs was underestimated in approximately 30% of cases. In real prescription, there was no significant difference in the use of NSAIDs, propacetamol and anti-spasmodic drugs. However, daily doses were more frequently underestimated, and opiate analgesics were less prescribed. Several points could explain these discrepancies: lack of knowledge about pharmacological properties, inadequate daily review of drug intake, underutilisation of opiates and insufficient clinical evaluation of pain in several centres. CONCLUSION: These results show a clear difference between intention to treat and real prescriptions for patients suffering from acute renal colic.
机译：目的：在不同国家，急性肾绞痛使用镇痛药的情况差异很大。为了评估法国急诊科（ED）急性肾绞痛的开药模式，本研究比较了急诊医生样本中处方，真实处方和循证数据的意图。方法：从法国西南部的9个急诊室中随机选择的51名急诊医生（27位医生和24位居民）的样本参加了这项观察性研究。第一步（2000年1月），向参与者询问模拟的急性肾绞痛病例。第二步，在6个月内（1999年7月至12月），回顾性地确定并收集了相同适应症的真实处方，并从医院的医学数据库中收集了这些处方。结果：在模拟病例中，除扑热息痛（70％），抗痉挛药（53％）和鸦片镇痛药（100％）外，在100％的病例中处方了非甾体类抗炎药（NSAID）。这些药物的每日剂量在大约30％的病例中被低估了。在实际处方中，使用非甾体抗炎药，扑热息痛和抗痉挛药物没有显着差异。但是，每天的剂量经常被低估，而鸦片止痛药的处方较少。以下几点可以解释这些差异：在一些中心，缺乏对药理特性的了解，对药物摄入的每日检查不足，鸦片制剂的利用不足以及对疼痛的临床评估不足。结论：这些结果表明急性肾绞痛患者的治疗意图与实际处方之间存在明显差异。

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