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Article Dans Une Revue American Journal of Emergency Medicine Année : 2021

Hydroxyzine for lowering patient's anxiety during prehospital morphine analgesia

Résumé

Study objective: Hydroxyzine is an antihistamine drug used for symptomatic relief of anxiety and tension. We hypothesized that managing the anxiety of patients with severe pain by adding hydroxyzine to a conventional intravenous morphine titration would relieve their pain more effectively.Methods: This was a randomized, double-blind, controlled group study of prehospital patients with acute pain scored greater than or equal to 6 on a 0-10 verbal numeric rating scale (NRS). Patients'anxiety was measured with the self-reported Face Anxiety Scale (FAS) ranking from 0 to 4. The percentage of patients with pain relief (NRS score ≤ 3) 15 min after the first injection was the primary outcome.Results: One hundred forty patients were enrolled. Fifty-one percent (95% CI 39% to 63%) of hydroxyzine patients versus 52% (95% CI 40% to 64%) of placebo patients reported a pain numeric rating scale score of 3 or lower at 15 min. Ninety-one percent (95% CI 83% to 98%) of patients receiving hydroxyzine reported no more severe anxiety versus 78% (95% CI 68% to 88%) of patients with placebo (p > 0.05). Adverse events were minor, with no difference between groups (6% in hydroxyzine patients and 14% in placebo patients).Conclusion: Addition of hydroxyzine to morphine in the prehospital setting did not reduce pain or anxiety in patients with acute severe pain and therefore is not indicated based on our results.
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hal-04149014 , version 1 (22-07-2024)

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Charles-Henri Houze-Cerfon, Frédéric Balen, Vanessa Houze-Cerfon, Julie Motuel, Florent Battefort, et al.. Hydroxyzine for lowering patient's anxiety during prehospital morphine analgesia: A prospective randomized double blind study. American Journal of Emergency Medicine, 2021, 50, pp.753-757. ⟨10.1016/j.ajem.2021.09.061⟩. ⟨hal-04149014⟩
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