Neuroleptanalgesia for acute abdominal pain: a systematic review.
abdominal pain
butryophenone
droperidol
haloperidol
neuroleptanalgesia
Journal
Journal of pain research
ISSN: 1178-7090
Titre abrégé: J Pain Res
Pays: New Zealand
ID NLM: 101540514
Informations de publication
Date de publication:
2019
2019
Historique:
entrez:
19
3
2019
pubmed:
19
3
2019
medline:
19
3
2019
Statut:
epublish
Résumé
Acute abdominal pain (AAP) comprises up to 10% of all emergency department (ED) visits. Current pain management practice is moving toward multi-modal analgesia regimens that decrease opioid use. This project sought to determine whether, in patients with AAP (population), does administration of butyrophenone antipsychotics (intervention) compared to placebo, usual care, or opiates alone (comparisons) improve analgesia or decrease opiate consumption (outcomes)? A structured search was performed in Cochrane CENTRAL, CINAHL, Database of Abstracts of Reviews of Effects, Directory of Open Access Journals, Embase, IEEE-Xplorer, Latin American and Caribbean Health Sciences Literature, Magiran, PubMed, Scientific Information Database, Scopus, TÜBİTAK ULAKBİM, and Web of Science. Clinical trial registries (ClinicalTrials.gov, World Health Organization International Clinical Trials Registry Platform, and Australian New Zealand Clinical Trials Registry), relevant bibliographies, and conference proceedings were also searched. Searches were not limited by date, language, or publication status. Studies eligible for inclusion were prospective randomized clinical trials enrolling patients (age ≥18 years) with AAP treated in acute care environments (ED, intensive care unit, postoperative). The butyrophenone must have been administered either intravenously or intra-muscularly. Comparison groups included placebo, opiate only, corticosteroids, non-steroidal anti-inflammatory drugs, or acetaminophen. We identified 7,217 references. Six studies met inclusion criteria. One study assessed ED patients with AAP associated with gastroparesis, whereas five studies assessed patients with postoperative AAP: abdominal hysterectomy (n=4), sleeve gastrectomy (n=1). Three of four studies found improvements in pain intensity with butyrophenone use. Three of five studies reported no change in postoperative opiate consumption, while two reported a decrease. One ED study reported no change in patient satisfaction, while one postoperative study reported improved satisfaction scores. Both extrapyramidal side effects (n=3) and sedation (n=3) were reported as unchanged. Based on available evidence, we cannot draw a conclusion on the efficacy or benefit of neuroleptanalgesia in the management of patients with AAP. However, preliminary data suggest that it may improve analgesia and decrease opiate consumption.
Sections du résumé
BACKGROUND
BACKGROUND
Acute abdominal pain (AAP) comprises up to 10% of all emergency department (ED) visits. Current pain management practice is moving toward multi-modal analgesia regimens that decrease opioid use.
OBJECTIVE
OBJECTIVE
This project sought to determine whether, in patients with AAP (population), does administration of butyrophenone antipsychotics (intervention) compared to placebo, usual care, or opiates alone (comparisons) improve analgesia or decrease opiate consumption (outcomes)?
METHODS
METHODS
A structured search was performed in Cochrane CENTRAL, CINAHL, Database of Abstracts of Reviews of Effects, Directory of Open Access Journals, Embase, IEEE-Xplorer, Latin American and Caribbean Health Sciences Literature, Magiran, PubMed, Scientific Information Database, Scopus, TÜBİTAK ULAKBİM, and Web of Science. Clinical trial registries (ClinicalTrials.gov, World Health Organization International Clinical Trials Registry Platform, and Australian New Zealand Clinical Trials Registry), relevant bibliographies, and conference proceedings were also searched. Searches were not limited by date, language, or publication status. Studies eligible for inclusion were prospective randomized clinical trials enrolling patients (age ≥18 years) with AAP treated in acute care environments (ED, intensive care unit, postoperative). The butyrophenone must have been administered either intravenously or intra-muscularly. Comparison groups included placebo, opiate only, corticosteroids, non-steroidal anti-inflammatory drugs, or acetaminophen.
RESULTS
RESULTS
We identified 7,217 references. Six studies met inclusion criteria. One study assessed ED patients with AAP associated with gastroparesis, whereas five studies assessed patients with postoperative AAP: abdominal hysterectomy (n=4), sleeve gastrectomy (n=1). Three of four studies found improvements in pain intensity with butyrophenone use. Three of five studies reported no change in postoperative opiate consumption, while two reported a decrease. One ED study reported no change in patient satisfaction, while one postoperative study reported improved satisfaction scores. Both extrapyramidal side effects (n=3) and sedation (n=3) were reported as unchanged.
CONCLUSION
CONCLUSIONS
Based on available evidence, we cannot draw a conclusion on the efficacy or benefit of neuroleptanalgesia in the management of patients with AAP. However, preliminary data suggest that it may improve analgesia and decrease opiate consumption.
Identifiants
pubmed: 30881092
doi: 10.2147/JPR.S187798
pii: jpr-12-787
pmc: PMC6396833
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
787-801Déclaration de conflit d'intérêts
Disclosure The contributions of AACB in this study were funded by the East Carolina University Brody School of Medicine Summer Scholar Research Program. The authors report no other conflicts of interest in this work.
Références
Am J Emerg Med. 2000 May;18(3):250-3
pubmed: 10830676
Clin Neuropharmacol. 2002 Sep-Oct;25(5):280-9
pubmed: 12410063
Arch Mal Appar Dig Mal Nutr. 1964 Jan-Feb;53:93-100
pubmed: 14122166
Zhonghua Yi Xue Za Zhi. 2003 Nov 25;83(22):1936-8
pubmed: 14703424
Eur J Emerg Med. 2004 Dec;11(6):309-12
pubmed: 15542986
Ir J Med Sci. 2002 Jul-Sep;171(3):141-4
pubmed: 15736352
J Clin Anesth. 2005 Jun;17(4):271-5
pubmed: 15950851
AANA J. 2005 Aug;73(4):273-5
pubmed: 16108408
Headache. 2006 May;46(5):781-7
pubmed: 16643581
J Pain. 2007 Jun;8(6):460-6
pubmed: 17306626
Acad Emerg Med. 2008 May;15(5):414-8
pubmed: 18439195
J Opioid Manag. 2008 May-Jun;4(3):163-6
pubmed: 18717511
Br J Surg. 2008 Nov;95(11):1331-8
pubmed: 18844267
Anesth Analg. 2010 Apr 1;110(4):1170-9
pubmed: 20142348
J Pain Symptom Manage. 2010 Apr;39(4):768-78
pubmed: 20226624
Intern Med J. 2012 Mar;42(3):281-8
pubmed: 20492010
Am J Emerg Med. 2011 Sep;29(7):711-6
pubmed: 20825873
Intern Emerg Med. 2011 Feb;6(1):69-78
pubmed: 20878501
Pain Med. 2010 Dec;11(12):1859-71
pubmed: 21040438
Pain Pract. 2011 May-Jun;11(3):290-6
pubmed: 21114616
J Clin Epidemiol. 2011 Apr;64(4):383-94
pubmed: 21195583
Cochrane Database Syst Rev. 2011 Jan 19;(1):CD005660
pubmed: 21249672
Clin Ther. 2010 Dec;32(14):2348-69
pubmed: 21353105
Masui. 2011 Jun;60(6):666-70
pubmed: 21710759
J Clin Psychiatry. 1979 Jul;40(7):323-6
pubmed: 222741
J Palliat Med. 2013 Jun;16(6):616-22
pubmed: 23556990
Am J Emerg Med. 2013 Jun;31(6):1003.e5-6
pubmed: 23583118
J Emerg Med. 2013 Sep;45(3):324-31
pubmed: 23602146
Braz J Anesthesiol. 2013 Sep-Oct;63(5):404-9
pubmed: 24263044
Eur J Pain. 2014 Aug;18(7):902-13
pubmed: 24449533
BMJ Open. 2014 Mar 25;4(3):e004288
pubmed: 24667382
J Palliat Med. 2015 Feb;18(2):114-9
pubmed: 25494475
Pain. 2015 Apr;156(4):569-76
pubmed: 25785523
J Am Acad Orthop Surg. 2015 May;23(5):267-71
pubmed: 25911660
Ann Emerg Med. 2015 Sep;66(3):253-259.e1
pubmed: 25952503
Acta Anaesthesiol Taiwan. 2015 Sep;53(3):89-94
pubmed: 26026843
J Emerg Med. 2015 Sep;49(3):326-34
pubmed: 26048068
J Palliat Med. 2015 Aug;18(8):660
pubmed: 26087240
AJR Am J Roentgenol. 2015 Dec;205(6):1222-9
pubmed: 26587929
Ann Gastroenterol Hepatol (Paris). 1989 May;25(3):123-8
pubmed: 2672998
Acad Emerg Med. 2016 Mar;23(3):331-41
pubmed: 26782787
PLoS One. 2016 Aug 08;11(8):e0159224
pubmed: 27501459
Ann Transl Med. 2016 Oct;4(19):362
pubmed: 27826565
BMJ Case Rep. 2017 Jan 4;2017:
pubmed: 28052951
Curr Drug Abuse Rev. 2017;9(2):142-147
pubmed: 28059034
N Engl J Med. 2017 Feb 16;376(7):663-673
pubmed: 28199807
Handb Exp Pharmacol. 2017;244:131-161
pubmed: 28275913
Am J Emerg Med. 2017 Aug;35(8):1118-1120
pubmed: 28320545
Acad Emerg Med. 2017 Nov;24(11):1307-1314
pubmed: 28646590
Chirurg. 1986 May;57(5):327-9
pubmed: 2873971
Obstet Gynecol. 2017 Dec;130(6):1261-1268
pubmed: 29112660
Pain Ther. 2017 Dec;6(2):193-202
pubmed: 29127600
Pediatrics. 2018 Jan;141(1):
pubmed: 29203521
Ann Surg. 2018 Jun;267(6):1056-1062
pubmed: 29215370
J Pain Res. 2017 Dec 12;10:2781-2788
pubmed: 29263692
Sci Rep. 2018 Mar 1;8(1):3873
pubmed: 29497125
Pain Ther. 2018 Jun;7(1):13-21
pubmed: 29691801
J Am Coll Surg. 2018 Aug;227(2):203-211
pubmed: 29746919
Curr HIV/AIDS Rep. 2018 Aug;15(4):293-301
pubmed: 29968173
Am J Public Health. 2018 Sep;108(9):1214-1219
pubmed: 30024809
S Afr Med J. 1977 Nov 12;52(21):835-7
pubmed: 345484
Masui. 1985 Mar;34(3):330-4
pubmed: 4021077
Mil Med. 1977 Dec;142(12):946-8
pubmed: 414162
Anesthesiology. 1968 Jul-Aug;29(4):834-8
pubmed: 4874159
Masui. 1971 May;20(5):403-6
pubmed: 5103813
Arzneimittelforschung. 1971 Jun;21(6):868-71
pubmed: 5109279
Int J Gynaecol Obstet. 1983 Apr;21(2):133-7
pubmed: 6136432
Cah Anesthesiol. 1984 Mar;32(3):225-7
pubmed: 6397237
Wiad Lek. 1982 May 1;35(3-4):187-9
pubmed: 7113201
Anaesthesia. 1982 Nov;37(11):1118-20
pubmed: 7137561
South Med J. 1981 Mar;74(3):364-5
pubmed: 7221641
Masui. 1995 Jul;44(7):1014-7
pubmed: 7637176
J Emerg Med. 1995 Jan-Feb;13(1):119-22
pubmed: 7782618
Gastrointest Endosc. 1977 Feb;23(3):142-4
pubmed: 838241
Br J Anaesth. 1993 Sep;71(3):435-6
pubmed: 8398529
Intensive Care Med. 1996 Oct;22(10):1043-7
pubmed: 8923067
Eur J Anaesthesiol. 1998 May;15(3):304-9
pubmed: 9649989