Droperidol V. haloperidol for sedation of aggressive behaviour in acute mental health: randomised controlled trial
Droperidol V. haloperidol for sedation of aggressive behaviour in acute mental health: randomised controlled trial
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DOI：
10.1192/bjp.bp.114.150227
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发表时间：
2015-03-01
影响因子：
10.5
通讯作者：
Isbister, Geoffrey K.
中科院分区：
文献类型：
--
作者：
Calver, Leonie;Drinkwater, Vincent;Isbister, Geoffrey K.
背景：激越和攻击是急性精神科的重要问题。对于哪种药物对这些患者的镇静最有效和最安全，几乎没有共识。目的比较氟哌啶醇与氟哌啶醇治疗躁动和攻击性患者的有效性和安全性。方法在一项隐藏式随机对照试验（ACTRN12611000565943）中，比较肌注氟哌啶醇（10mg）与肌注氟哌啶醇（10mg）对精神科重症监护病房急性行为障碍成年患者的治疗效果。主要终点为120 ml内镇静时间，次要终点为额外镇静的使用、不良事件和工作人员伤害。结果584例患者中，110例随机分配氟哌啶醇组，118例随机分配氟哌啶醇组。210例（92%）患者在120 mm范围内有效镇静。氟哌啶醇组至镇静的中位时间为20min（四分位数范围15-30，范围10-75），氟哌啶醇组为25min（四分位数范围15-30，范围10-115），差异无统计学意义（P=0.89）。氟哌啶醇组更常使用额外镇静（13% vs 5%， P=0.06），但氟哌啶醇组不良反应较少（1% vs 5%， P=0.12）。有8名工作人员受伤。结论氟哌啶醇和氟哌啶醇对急性行为障碍患者均有镇静作用。
BackgroundAgitation and aggression are significant problems in acute psychiatric units. There is little consensus on which drug is most effective and safest for sedation of these patients.AimsTo compare the effectiveness and safety of haloperidol v. droperidol for patients with agitation and aggression.MethodIn a masked, randomised controlled trial (ACTRN12611000565943) intramuscular droperidol (10 mg) was compared with intramuscular haloperidol (10mg) for adult patients with acute behavioural disturbance in a psychiatric intensive care unit. The primary outcome was time to sedation within 120 ml Secondary outcomes were use of additional sedation, adverse events and staff injuries.ResultsFrom 584 patients, 110 were randomised to haloperidol and 118 to droperidol. Effective sedation occurred in 210 (92%) patients within 120 mm. There was no significant difference in median time to sedation: 20min (interquartile range 15-30, range 10-75) for haloperidol v. 25min (IQR 15-30, range 10-115) for droperidol (P=0.89). Additional sedation was used more often with haloperidol (13% v. 5%, P=0.06), but adverse effects were less common with haloperidol (1% v. 5%, P=0.12). There were 8 staff injuries.ConclusionsBoth haloperidol and droperidol were effective for sedation of patients with acute behavioural disturbance.