Selection of cervicalgia›s analgesia management in the prehospital stage in everyday ambulance operations and possible emergency situations

Purpose of the study : to evaluate the analgesic efficacy of ketoprofen, ketorolac, sodium metamizole (combination with pithophenone and fenpiverinium bromide) and percutaneous neurostimulation method for the choice of optimal analgesia of nonspecific cervicalgia in the conditions of daily ambulance work and possible emergency situations. Materials and methods of the study : in 160 patients in conditions of real work of emergency medical aid in 7 cities of the Russian Federation were used: 1 gr. — Ketoprofen («Ketonal») (100 mg), intramuscularly (n=31); 2 gr. — ketorolac tromethamine («Ketorol») (30 mg), intramuscularly (n=25); 3 gr. — Metamizole sodium 500 mg, pitofenone 2 mg, fenpiverinium bromide 20 mcg («Baralgin») in 1 ml, 5 ml intramuscularly (n=22); 4 gr. — percutaneous neurostimulation (CHENS-SCENAR-02) (n=82). Results of the study : cervicalgia was accompanied by complaints of headache (86%), «noise» in the head (33%), dizziness (25%), less frequently by complaints of paresthesias in the hands, cardialgia, nausea, agitation or lethargy in antalgic posture. Reliable analgesic efficacy with evaluation on visual analogue scale is realized by 10 minutes by 20–25% decrease of pain; by 40 minutes by 70%; reduction of cranialgia to 20–40% of the initial one is noted. A slight decrease in BP, HR and HR was registered; ketorolac and SCENAR-therapy were the most effective in these parameters. There were no significant side effects in any group. Conclusion . Ketoprofen and ketorolac are the most effective in the conditions of daily activities of the emergency department and possible emergencies, and percutaneous neurostimulation is also possible in conditions of drug deprivation and/or contraindications to pharmacotherapy.