Morteza Talebi Doluee; Zahra Abbasi Shaye; Mahdi Talebi; Abbas Farhadi
Volume 23, Issue 2 , 2021
Abstract
Background: Delirium is a psychiatric syndrome observed among patients with critical psychiatric disorders. Haloperidol is now one of the first-line drugs for the treatment of delirium. However, quetiapine can be considered as an appropriate substitute in patients with a high risk of extrapyramidal symptoms ...
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Background: Delirium is a psychiatric syndrome observed among patients with critical psychiatric disorders. Haloperidol is now one of the first-line drugs for the treatment of delirium. However, quetiapine can be considered as an appropriate substitute in patients with a high risk of extrapyramidal symptoms or long QT syndrome.
Objectives: This study aimed to compare the effectiveness of intramuscular haloperidol and oral quetiapine to control delirium in patients in the emergency department and intensive care unit.
Methods: This randomized clinical trial was performed during 2017-2018 on patients with delirium who were referred to the emergency department and intensive care unit of Imam Reza Hospital (referral center), Mashhad, Iran. Patients were divided into two groups of 100 patients per group through a random allocation technique . In this study, 5 mg of intramuscular haloperidol every 12 hours and 25 mg of oral quetiapine were prescribed daily for the patients in the control and intervention groups, respectively. The delirium severity score of each patient was evaluated before and three days after the intervention through Delirium Rating Scale-Revised-98.
Results: In this study, the mean±SD age of participants was 60.2±14.1 years. The findings indicated that no significant difference was observed between haloperidol (22.7±1.9) and quetiapine (22.7±2.2) groups in terms of the baseline delirium severity score (P=0.95). The mean delirium severity scores of patients in haloperidol and quetiapine groups were 25.6±2.1 and 25.2±2.5, respectively. Based on the obtained results, the difference between the delirium severity scores of both groups was not statistically significant (P=0.24).
Conclusion: Based on the results, oral quetiapine has a similar effect as intramuscular haloperidol and can be used as a substitute to this medicine for controlling the symptoms of patients with delirium.
Morteza Talebi Doluee; Behrang Rezvani Kakhki; Hamid Heidarian Mir; Mahsa Fateminayyeri; Farideh Madanitorbati; Somayyehalsadat Hosseini
Volume 21, Issue 4 , 2019, Pages 1-5
Abstract
Background: Sickle cell disease (SCD) is a congenital hemoglobinopathy. A low Hb level and high hemoglobin-to-hematocrit ratio may lead to the vaso-occlusive crisis in patients, for the management of which hyperbaric oxygen, hydration, and pain relief therapy are proposed.Objectives: In this study, we ...
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Background: Sickle cell disease (SCD) is a congenital hemoglobinopathy. A low Hb level and high hemoglobin-to-hematocrit ratio may lead to the vaso-occlusive crisis in patients, for the management of which hyperbaric oxygen, hydration, and pain relief therapy are proposed.Objectives: In this study, we sought to compare the effects of morphine and ketorolac on relieving painful sickle cell crisis.Methods: In this double-blind, randomized clinical trial, we recruited 92 SCD patients who referred to the Emergency Department of a university-affiliated hospital, in Mashhad, Iran, from December 2016 to May 2017. The patients were randomly assigned to two groups of ketorolac and morphine injections for relieving pain crisis according to the clinical conditions of the patients. Pain sever- ity was measured by the visual analogue scale before and after the intervention. Data were analyzed using SPSS software.Results: A total of 92 SCD patients were evaluated, while, 19 (21%) were female and 73 (79%) were male, with the mean age of 20.77 ± 8.6 years. At the pre-injection phase, the mean pain scores were 9.1 ± 0.4 and 9.1 ± 0.7 in the ketorolac and morphine groups, respec- tively. After the intervention, the mean pain scores were 3.7 ± 1.2 and 4.9 ± 2.1 in the ketorolac and morphine groups, respectively. A significant association was found between the pain score after drug injection and the administered drug (P = 0.006).Conclusions: The management of pain crisis with ketorolac injection yielded the same results as the morphine injection in SCD pa- tients. However, ketorolac was found to be associated with fewer side effects than morphine; thus, it can be beneficial for managing SCD patients suffering pain crisis.
