Gerilim Tipi Baş Ağrısının Akut Tedavisinde İntravenöz İbuprofen ve Deksketoprofenin Randomize Çift Kör Karşılaştırılması

Yıl 2022, , 116 - 122, 29.12.2022

Safa Dönmez , Ahmet Burak Erdem , Alp Şener , Abdullah Osman Kocak

https://doi.org/10.56728/dustad.1194120

Öz

Özet: Gerilim tipi baş ağrılarının (GTBA) akut tedavisinde nonsteroid antiinflamatuar ilaçlar rutin ve ilk tercih olarak kullanılmaktadır. Bu çalışmanın amacı, GTBA tedavisinde parenteral olarak uygulanan tek doz deksketoprofen ve ibuprofen'in analjezik etkinliğini karşılaştırmaktır. Çalışmamız randomize, çift kör bir modelle tasarlandı. Gerilim tipi baş ağrısı olan hastalar deksketoprofen ve ibuprofen gruplarına randomize edildi. Hastaların ağrı skorları 10 üniteli Numerik Rating Skala (NRS) ile 0, 15, 30 ve 60. dakikalarda kaydedildi. Bu hastalardan 45'i (%50) deksketoprofen tedavisi alacak gruba, 45'i (%50) ibuprofen tedavisi alacak gruba dahil edildi. Hastalarımızın 54'ü kadın, 36'sı erkekti. Analjezik 1 ile tedavi edilen grupta ortalama NRS skorlarındaki farklar sırasıyla 5, 15, 30 ve 60. dakikaların sonunda 2.0, 4.0, 5.22, 6.0 ve analjezik 2 için sırasıyla 2, 5, 6.36, 7 idi. Otuzuncu dakika dışında tüm zaman noktalarında ilaç etkinliği arasında anlamlı bir fark bulunmazken, ibuprofenin ağrıyı azaltmadaki etkinliği 30. dakikada daha anlamlıydı (p=.015). Çalışmamız sonucunda 60. dakika sonunda parenteral uygulanan deksketoprofen 50 mg ile ibuprofen 800 mg'ın analjezik etkinliği arasında anlamlı fark bulunmazken, ibuprofen 800 mg'ın analjezik etkinliği 30. dakikada daha üstündü.

Anahtar Kelimeler

gerilim tipi baş ağrısı, deksketoprofen, ibuprofen, acil servis, nümerik derecelendirme ölçeği

Destekleyen Kurum

Yok

Proje Numarası

Yok

Teşekkür

Yok

Randomized Double-Blind Comparison of Intravenous Ibuprofen and Dexketoprofen in the Acute Treatment of Tension-Type Headache

Öz

Abstract: Non-steroidal anti-inflammatory drugs are used routinely and first choice in the acute treatment of tension-type headaches(TTH). The aim of this study is to compare the analgesic efficacy of parenterally administered single dose dexketoprofen and ibuprofen in the treatment of TTH. Our study was designed in a randomized, double-blind model. Patients with tension headache were randomized to dexketoprofen and ibuprofen groups. Pain scores of the patients were recorded at 0, 15, 30, and 60 minutes with a 10-unit Numeric Rating Scale (NRS). Of these patients, 45 (50%) were included in the group to receive dexketoprofen treatment, and 45 (50%) to receive ibuprofen treatment. In total, 54 of our patients were female and 36 were male. The differences in mean NRS scores in the group treated with analgesic 1 were 2.0, 4.0, 5.22, 6.0 at the end of the 5th, 15th, 30th and 60th minutes, respectively, and 2, 5, 6.36, 7 for analgesic 2, respectively. While there was no significant difference between drug efficacy at all time points except the 30th minute, the efficacy of ibuprofen in reducing pain was more significant at the 30th minute (p=.015). As a result of our study, there was no significant difference between the analgesic efficacy of parenterally administered dexketoprofen 50 mg and ibuprofen 800 mg at the end of the 60th minute, while ibuprofen 800 mg was superior in terms of analgesic efficacy at the 30th minute.

Anahtar Kelimeler

tension type headache, dexketoprofen, ibuprofen, emergency department, numerical rating scale

Proje Numarası

Yok

Kaynakça

• 1. Veys L, Derry S, Moore RA. Ketoprofen for episodic tension-type headache in adults. Cochrane Database Syst Rev. 2016;9(9):CD012190. doi: 10.1002/14651858.CD012190.pub2.
• 2. Stone J, Carson A, Duncan R, Roberts R, Warlow C, Hibberd C, et al. Who is referred to neurology clinics?- the diagnoses made in 3781 new patients. Clin Neurol Neurosurg. 2010;112 (9):747-51. doi: 10.1016/j.clineuro.2010.05.011.
• 3. Bigal ME, Bordini CA, Speciali JG. Etiology and distribution of headaches in two Brazilian primary care units. Headache. 2000;40 (3):241-7. doi: 10.1046/j.1526-4610.2000.00035.x.
• 4. Jensen R, Olesen J. Initiating mechanisms of experimentally induced tension-type headache. Cephalalgia. 1996;16 (3):175-82; discussion 138-9. doi: 10.1046/j.1468-2982.1996.1603175.x.
• 5. Coskun O. Gerilim tipi baş ağrısı ve tedavisi [Tension Type Headache and Treatment]. Turkiye Klinikleri J Neurol-Special Topics. 2008;1(1):22-6.
• 6. Bushra R, Aslam N. An overview of clinical pharmacology of Ibuprofen. Oman Med J. 2010;25 (3):155-1661. doi: 10.5001/omj.2010.49.
• 7. Barbanoj MJ, Antonijoan RM, Gich I. Clinical pharmacokinetics of dexketoprofen. Clin Pharmacokinet. 2001;40 (4):245-62. doi: 10.2165/00003088-200140040-00002.
• 8. van Gerven JM, Schoemaker RC, Jacobs LD, Reints A, Ouwersloot-van der Meij MJ, Hoedemaker HG, et al. Self-medication of a single headache episode with ketoprofen, ibuprofen or placebo, home-monitored with an electronic patient diary. Br J Clin Pharmacol. 1996;42 (4):475-81. doi: 10.1046/j.1365-2125.1996.43613.x.
• 9. Lange R, Lentz R. Comparison ketoprofen, ibuprofen and naproxen sodium in the treatment of tension-type headache. Drugs Exp Clin Res. 1995;21 (3):89-96.
• 10. Kahriman A, Zhu S. Migraine and Tension-Type Headache. Semin Neurol. 2018;38(6):608-18. doi: 10.1055/s-0038-1673683.
• 11. Russell MB. Tension-type headache in 40-year-olds: a Danish population-based sample of 4000. J Headache Pain. 2005;6 (6):441-7. doi: 10.1007/s10194-005-0253-3.
• 12. Lavados PM, Tenhamm E. Epidemiology of tension-type headache in Santiago, Chile: a prevalence study. Cephalalgia. 1998;18 (8):552-8. doi: 10.1046/j.1468-2982.1998.1808552.x.
• 13. Diamond S, Balm TK, Freitag FG. Ibuprofen plus caffeine in the treatment of tension-type headache. Clin Pharmacol Ther. 2000;68 (3):312-9. doi: 10.1067/mcp.2000.109353.
• 14. Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia. 2013;33 (9):629-808. doi: 10.1177/0333102413485658.
• 15. Busson M. Update on ibuprofen: review article. J Int Med Res. 1986;14(2):53-62. doi: 10.1177/030006058601400201.
• 16. Packman B, Packman E, Doyle G, Cooper S, Ashraf E, Koronkiewicz K, et al. Solubilized ibuprofen: evaluation of onset, relief, and safety of a novel formulation in the treatment of episodic tension-type headache. Headache. 2000;40 (7):561-7. doi: 10.1046/j.1526-4610.2000.00087.x.
• 17. Diamond S. Ibuprofen versus aspirin and placebo in the treatment of muscle contraction headache. Headache. 1983;23 (5):206-10. doi: 10.1111/j.1526-4610.1983.hed2305206.x.
• 18. Packman E, Leyva R, Kellstein D. Onset of analgesia with ibuprofen sodium in tension-type headache: a randomized trial. J Pharm Health Care Sci. 2015;1:13. doi: 10.1186/s40780-015-0012-9.
• 19. Verhagen AP, Damen L, Berger MY, Passchier J, Merlijn V, Koes BW. Is any one analgesic superior for episodic tension-type headache? J Fam Pract. 2006;55 (12):1064-72.