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Advisor(s)
Abstract(s)
Eficácia da administração da cetamina intranasal na gestão da dor aguda.
Contexto: A administração de medicação analgésica intranasal é de fácil acesso e rápida
ação, sendo cada vez mais utilizada e com sucesso para o alívio da dor. Este estudo surge
na sequência de determinar a eficácia e efeitos secundários relacionados com a
administração intranasal da cetamina, em comparação com a administração de opioides, por
diferentes vias.
Objetivo: Determinar a eficácia na administração da cetamina intranasal, em comparação com
a administração de opioides endovenosos e intranasais.
Métodos: A realização da revisão sistemática com meta-análise seguiu os princípios
propostos pelo Cochrane Handbook. A análise crítica, a extração e a síntese dos dados foram
realizadas por dois investigadores, de forma isolada, e a análise estatística efetuada com
recurso ao programa RevMan 5.2.8.
Resultados: Foram incluídos três randomized controlled trials, envolvendo um total de 254
participantes. Os resultados da meta-análise apontam para a inexistência de diferenças
significativas entre a administração de cetamina intranasal comparativamente à administração
de opioides IV e IN, para alívio da dor aguda aos 5, 15 e 30 minutos. No que se refere aos
outcomes: cefaleias, náuseas e tonturas como efeitos secundários, estes são mais evidentes
no grupo de opioides, comparativamente ao da cetamina IN, embora sem significância
estatística.
Conclusões: A eficácia na administração da cetamina intranasal é uma alternativa válida
perante os analgésicos opioides na gestão da dor aguda, apresentando relevância clínica na
redução de efeitos secundários.
Descritores: Administração intranasal; Cetamina; Analgésicos opioides; Dor
Efficacy of intranasal ketamine administration in acute pain management. Framework: The administration of intranasal analgesic medication is easily accessible and fast acting, being increasingly and successfully used for pain relief. This study emerges from the intent of determining the efficacy and side effects related to intranasal administration of ketamine compared to opioid administration by different routes. Objective: To determine the efficacy of intranasal ketamine administration, compared to intravenous and intranasal opioid administration. Methods: The systematic review with meta-analysis followed the principles proposed by the Cochrane Handbook. The critical analysis, extraction and synthesis of data were performed by two investigators, separately, and the statistical analysis was performed using the RevMan 5.2.8 software. Results: Three randomized controlled trials involving a total of 254 participants were included. The results of the meta-analysis indicate that there are no significant differences between the administration of intranasal ketamine and IV and IN opioids for acute pain relief at 5, 15 and 30 minutes. As for the outcomes: headaches, nausea and dizziness as side effects, which were more evident in the opioid group compared to the ketamine IN group, although without statistical significance. Conclusions: The efficacy of intranasal ketamine administration is a valid alternative to opioid analgesics in the management of acute pain, with clinical relevance in reducing side effects. Descriptors: Intranasal administration; Ketamine; Opioid analgesics; Pain
Efficacy of intranasal ketamine administration in acute pain management. Framework: The administration of intranasal analgesic medication is easily accessible and fast acting, being increasingly and successfully used for pain relief. This study emerges from the intent of determining the efficacy and side effects related to intranasal administration of ketamine compared to opioid administration by different routes. Objective: To determine the efficacy of intranasal ketamine administration, compared to intravenous and intranasal opioid administration. Methods: The systematic review with meta-analysis followed the principles proposed by the Cochrane Handbook. The critical analysis, extraction and synthesis of data were performed by two investigators, separately, and the statistical analysis was performed using the RevMan 5.2.8 software. Results: Three randomized controlled trials involving a total of 254 participants were included. The results of the meta-analysis indicate that there are no significant differences between the administration of intranasal ketamine and IV and IN opioids for acute pain relief at 5, 15 and 30 minutes. As for the outcomes: headaches, nausea and dizziness as side effects, which were more evident in the opioid group compared to the ketamine IN group, although without statistical significance. Conclusions: The efficacy of intranasal ketamine administration is a valid alternative to opioid analgesics in the management of acute pain, with clinical relevance in reducing side effects. Descriptors: Intranasal administration; Ketamine; Opioid analgesics; Pain
Description
Keywords
Administração intranasal Cetamina - administração e dosagem Dor aguda Revisão sistemática Vias de administração de medicamentos Acute pain Administration, intranasal Drug administration routes Ketamine - administration and dosage Systematic review