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Prähospitale Analgesie mit Nalbuphin und Paracetamol im Vergleich zu Piritramid durch Notfallsanitäter*innen – eine multizentrische Observationsstudie.

Authors :
Deslandes, Marvin
Deicke, Martin
Grannemann, Julia Johanna
Hinkelbein, Jochen
Hoyer, Annika
Kalmbach, Matthias
Kobiella, André
Strickmann, Bernd
Plappert, Thomas
Jansen, Gerrit
Source :
Die Anaesthesiologie. Sep2024, Vol. 73 Issue 9, p583-590. 8p.
Publication Year :
2024

Abstract

Objective: Following recent changes to the German Narcotics Act, this article examines prehospital analgesia by paramedics using piritramide vs. nalbuphine + paracetamol. Material and methods: Prehospital analgesia administered by paramedics from the Fulda (piritramide) and Gütersloh (nalbuphine + paracetamol) emergency services was compared regarding pain intensity at the beginning and end of the mission, measured using the numeric rating scale (NRS). Additionally, an analysis of the resulting complications was carried out. Results: In this study 2429 administrations of analgesia were evaluated (nalbuphine + paracetamol: 1635, 67.3%, initial NRS: 8.0 ± 1.4, end of NRS: 3.7 ± 2.0; piritramide: 794, 32.7%, initial NRS: 8.5 ± 1.1, end of NRS: 4.5 ± 1.6). Factors influencing NRS change were initial NRS (regression coefficient, RC: 0.7075, 95% confidence interval, CI: 0.6503–0.7647, p < 0.001), treatment with nalbuphine + paracetamol (RC: 0.6048, 95% CI: 0.4396–0.7700, p < 0.001). Treatment with nalbuphine + paracetamol (n = 796 (48.7%)) compared to piritramide (n = 190 (23.9%)) increased the odds of achieving NRS < 4 (odds ratio, OR: 2.712, 95% CI: 2.227–3.303, p < 0.001). Complications occurred in n = 44 (5.5%) with piritramide and in n = 35 (2.1%) with nalbuphine + paracetamol. Risk factors for complications were analgesia with piritramide (OR: 2.699, 95% CI: 1.693–4.301, p < 0.001), female sex (OR: 2.372, 95% CI: 1.396–4.029, p = 0.0014), and age (OR: 1.013, 95% CI: 1.002–1.025, p = 0.0232). Conclusion: Compared with piritramide, prehospital analgesia with nalbuphine + paracetamol has favorable effects in terms of analgesic efficacy and complication rates and should therefore be considered in future recommendations for paramedics. [ABSTRACT FROM AUTHOR]

Details

Language :
German
ISSN :
27316858
Volume :
73
Issue :
9
Database :
Academic Search Index
Journal :
Die Anaesthesiologie
Publication Type :
Academic Journal
Accession number :
179295670
Full Text :
https://doi.org/10.1007/s00101-024-01449-7