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Ibuprofen Best for Kids' Injury Pain
By Kathleen Doheny
HealthDay Reporter
Monday, March 5, 2007; 12:00 AM
MONDAY, March 5 (HealthDay News) -- The painkiller ibuprofen -- found in over-the-counter Advil and Motrin -- worked better than two other analgesics commonly used in hospital emergency departments to relieve children's pain from musculoskeletal injuries such as sprained ankles, a new Canadian study shows.
A standard OTC dose of ibuprofen was compared to equivalent doses of acetaminophen (the active ingredient in Tylenol) and to codeine, said Dr. Eric Clark, the lead author of the study and an emergency medicine specialist at the University of Ottawa School of Medicine.
The study is published in the March issue of the journalPediatrics.
"No one had done comparison studies on the pain medications we use [on children] shift after shift," Clark said. "Some of us were already using ibuprofen more than the others, and I think this [study] just confirms our clinical experience."
Clark's team evaluated 300 children, ages 6 to 17, who were brought to the emergency department of the Children's Hospital of Eastern Ontario with pain from a musculoskeletal injury to the extremities, neck or back occurring sometime in the prior 48 hours. Each child was first asked to describe their pain, using a commonly used tool in which they rate their pain, from "no pain" to "the worst pain they have ever felt."
Next, Clark's team randomly assigned the children to one of the three treatment groups. The children, parents and research assistants who asked them about pain did not know which medication each child got. Each was given a standard dose orally, prescribed by the child's weight.
After the children took the medicine, they were asked to describe the pain every 30 minutes for two hours, using the same description as before.
"The primary outcome [we were looking at] was at one hour," Clark said. At the one-hour mark, the ibuprofen group had better pain relief.
"On a 100 millimeter [total possible] pain score, the ibuprofen group dropped by about 24 millimeters on average, the acetaminophen group 12 millimeters and the codeine group 11 millimeters," Clark said.
Those given ibuprofen were least likely to ask for more medicine for pain relief after an hour, they found, another good indication the medicine was working.
A pain score below 30 millimeters is considered adequate relief, Clark said. "About 50 percent of the ibuprofen group got there, but only 36 percent of the acetaminophen group vs. only 40 percent of the codeine group."
The results about which medicine worked best on children's acute pain slightly surprised Dr. Dennis Woo, chair of pediatrics at Santa Monica-UCLA and Orthopaedic Hospital in Santa Monica, Calif. "I would have guessed codeine," Woo said.
Indeed, said Clark, codeine does have the reputation among many doctors of being the better choice.
But the results are actually good news, Woo said. He personally does not like to use codeine for kids' pain management because "it spaces them out," he said.
Will the study results change prescribing habits in emergency departments when kids are brought in acute pain? "I hope so," Clark said. "This is a very common problem that all kinds of doctors and emergency pediatricians see."
In the pediatric department he studied, Clark wrote, about 10 percent of all visits are for these kinds of musculoskeletal injuries.
The take-home message for parents? "When we send parents home with children with bumps, bruises and broken bones, we suggest parents use ibuprofen as well," Clark said. That also goes, he said, for treating musculoskeletal injuries not severe enough to seek medical care.
More information
To learn more about pain relievers, visit the American Academy of Family Physicians.
SOURCES: Eric Clark, M.D., emergency medicine specialist, University of Ottawa School of Medicine, Ottawa, Canada; Dennis Woo, M.D., chair of pediatrics, Santa Monica-UCLA and Orthopaedic Hospital, Santa Monica, Calif.; March 2007,Pediatrics
本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。
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Ibuprofen Best for Kids' Injury Pain
布洛芬对儿科损伤疼痛最益
MONDAY, March 5 (HealthDay News) -- The painkiller ibuprofen -- found in over-the-counter Advil and Motrin -- worked better than two other analgesics commonly used in hospital emergency departments to relieve children's pain from musculoskeletal injuries such as sprained ankles, a new Canadian study shows.
周一，3月5日（每日健康新闻）--加拿大一项新的研究表明，镇痛药布洛芬（非处方药商品名为Advil和Motrin）与其它另外两种医院急诊室常用镇痛药相比，对缓解儿童肌肉骨骼损伤（如踝关节扭伤）所引起的疼痛更为有效。
A standard OTC dose of ibuprofen was compared to equivalent doses of acetaminophen (the active ingredient in Tylenol) and to codeine, said Dr. Eric Clark, the lead author of the study and an emergency medicine specialist at the University of Ottawa School of Medicine.
布洛芬标准的非处方药剂量与对乙酰氨基酚（泰诺的活性成分）和可待因的剂量相当，本研究首席研究员、渥太华大学医学院急诊医学专家埃里克.克拉克博士说道。
The study is published in the March issue of the journal Pediatrics.
该研究发表在《儿科杂志》三月份刊上。
"No one had done comparison studies on the pain medications we use [on children] shift after shift," Clark said. "Some of us were already using ibuprofen more than the others, and I think this [study] just confirms our clinical experience."
“没有人对不同的（儿童）疼痛治疗药物进行比较性研究，我们许多医生已经更多的应用布洛芬，我认为该研究正好证实了我们的经验。”克拉克说道。
Clark's team evaluated 300 children, ages 6 to 17, who were brought to the emergency department of the Children's Hospital of Eastern Ontario with pain from a musculoskeletal injury to the extremities, neck or back occurring sometime in the prior 48 hours. Each child was first asked to describe their pain, using a commonly used tool in which they rate their pain, from "no pain" to "the worst pain they have ever felt."
克拉克研究小组对前来东安大略省儿童医院急诊部就诊的300名儿童进行了考察，他们的年龄在6-17岁之间，疼痛范围从肌肉骨骼损伤到肢体、颈部和背部疼痛，就诊时间多在出现疼痛的48小时之内。首先要求每个儿童用常用的评价方法描述他们的疼痛程度，等级从“不痛”到“感觉到从未这么痛”。
Next, Clark's team randomly assigned the children to one of the three treatment groups. The children, parents and research assistants who asked them about pain did not know which medication each child got. Each was given a standard dose orally, prescribed by the child's weight.
接下来，克拉克研究小组将他们随机分配到三个治疗小组，询问孩子们的家长和研究助理并不知道他们将进行哪种药物治疗。每个儿童根据其体重口服标准剂量的药物。
After the children took the medicine, they were asked to describe the pain every 30 minutes for two hours, using the same description as before.
孩子们服药后2小时内，每隔30分钟要求他们按照前面的疼痛评价方法描述他们的疼痛程度。
"The primary outcome [we were looking at] was at one hour," Clark said. At the one-hour mark, the ibuprofen group had better pain relief.
“最初结果（我们所关注的）出现在服药后1小时，”克拉克说道。在服药1小时时，布洛芬组儿童的疼痛已经有了较好的缓解。
"On a 100 millimeter [total possible] pain score, the ibuprofen group dropped by about 24 millimeters on average, the acetaminophen group 12 millimeters and the codeine group 11 millimeters," Clark said.
“如以100毫米（可能达到的最高值）作为疼痛评价分值的话，布洛芬组平均降低24毫米，对乙酰氨基酚组和可待因组分别降低12毫米和11毫米。”克拉克说道。
Those given ibuprofen were least likely to ask for more medicine for pain relief after an hour, they found, another good indication the medicine was working.
他们发现，服用布洛芬的儿童在服药1小时后，要求再次服用镇痛药的人数最少，这也很好地表明药物正在发挥作用。
A pain score below 30 millimeters is considered adequate relief, Clark said. "About 50 percent of the ibuprofen group got there, but only 36 percent of the acetaminophen group vs. only 40 percent of the codeine group."
克拉克称，疼痛分值降低30毫米即可视为疼痛得到满意的缓解。“布洛芬组约50%的儿童达到这一分值，而对乙酰氨基酚组和可待因组仅为36%和40%。”
The results about which medicine worked best on children's acute pain slightly surprised Dr. Dennis Woo, chair of pediatrics at Santa Monica-UCLA and Orthopaedic Hospital in Santa Monica, Calif. "I would have guessed codeine," Woo said.
对于这些有关那种药物对儿童急性疼痛更为有效的研究结果，丹尼斯.吴博士略感惊讶。吴博士是位于Santa Monica加州大学洛杉矶分校和整形外科医院的小儿科主任。“如果让我猜的话，应是可待因。”吴说道。
Indeed, said Clark, codeine does have the reputation among many doctors of being the better choice.
的确如此，克拉克说，可待因确实在许多医生中享有盛誉而成为首选。
But the results are actually good news, Woo said. He personally does not like to use codeine for kids' pain management because "it spaces them out," he said.
但是该研究结果确实是个好消息，吴说道。他本人并不喜欢给小孩们应用可待因来治疗疼痛，因为“它使孩子们昏昏沉沉。”，他说道。
Will the study results change prescribing habits in emergency departments when kids are brought in acute pain? "I hope so," Clark said. "This is a very common problem that all kinds of doctors and emergency pediatricians see."
当孩子们再因急性疼痛来急诊就诊时，该研究结果是否回改变医生们的用药习惯呢？克拉克说：“我希望如此，急性疼痛是所有各科医生和小儿急诊医生极其常见的疾病。”
In the pediatric department he studied, Clark wrote, about 10 percent of all visits are for these kinds of musculoskeletal injuries.
克拉克在文章中写道，在他从事该研究的小儿科，约10%的就诊患者属于这些肌肉骨骼损伤。
The take-home message for parents? "When we send parents home with children with bumps, bruises and broken bones, we suggest parents use ibuprofen as well," Clark said. That also goes, he said, for treating musculoskeletal injuries not severe enough to seek medical care.
给父母的建议是什么呢？“当父母和他们受伤的孩子回家时，我们建议父母最好还是应用布洛芬。”克拉克说道。对于那些肌肉骨骼损伤不太严重而无需前来就诊的孩子们也是如此。
More information
更多信息
To learn more about pain relievers, visit the American Academy of Family Physicians.
欲知更多有关镇痛药的信息，请登陆“美国家庭医生学会”网站。
SOURCES: Eric Clark, M.D., emergency medicine specialist, University of Ottawa School of Medicine, Ottawa, Canada; Dennis Woo, M.D., chair of pediatrics, Santa Monica-UCLA and Orthopaedic Hospital, Santa Monica, Calif.; March 2007,Pediatrics
来源：埃里克.克拉克，医学博士，加拿大渥太华大学医学院急诊医学专家；丹尼斯.吴，医学博士，加州Santa Monica加州大学洛杉矶分校和整形外科医院的小儿科主任；《儿科杂志》2007年3月。
编译：
布洛芬对儿科损伤疼痛最益
据美国“每日健康”3月5日报道，加拿大一项新的研究表明，镇痛药布洛芬（非处方药商品名为Advil和Motrin）与其它另外两种医院急诊室常用镇痛药乙酰氨基酚（泰诺的活性成分）和可待因相比，对缓解儿童肌肉骨骼损伤（如踝关节扭伤）所引起的疼痛更为有效。
这项由渥太华大学医学院急诊医学专家埃里克.克拉克博士领衔的研究小组，对前来东安大略省儿童医院急诊部就诊的300名儿童进行了考察，他们的年龄在6-17岁之间，疼痛范围从肌肉骨骼损伤到肢体、颈部和背部疼痛，就诊时间在出现疼痛的48小时之内。他们首先要求每个儿童用常用的评价方法描述他们的疼痛程度，等级从“不痛”到“感觉到从未这么痛”。
接下来，研究小组将他们随机分配到三个治疗小组，询问孩子们的家长和研究助理并不知道他们将进行哪种药物治疗。每个儿童根据其体重口服标准剂量的三种不同药物药物。
孩子们服药后2小时内，每隔30分钟要求他们按照前面的疼痛评价方法描述他们的疼痛程度。
在服药1小时时，布洛芬组儿童的疼痛已经有了较好的缓解。“如以100毫米（可能达到的最高值）作为疼痛评价分值的话，布洛芬组平均降低24毫米，对乙酰氨基酚组和可待因组分别降低12毫米和11毫米。”克拉克说道。
他们发现，服用布洛芬的儿童在服药1小时后，要求再次服用镇痛药的人数最少，这也很好地表明药物正在发挥作用。
克拉克称，疼痛分值降低30毫米即可视为疼痛得到满意的缓解。“布洛芬组约50%的儿童达到这一分值，而对乙酰氨基酚组和可待因组仅为36%和40%。”
对于这一研究结果，加州大学洛杉矶分校和整形外科医院的小儿科主任丹尼斯.吴博士略感惊讶。“如果让我猜的话，应是可待因。”吴说道。
的确如此，克拉克说，可待因确实在许多医生中享有盛誉而成为首选。
但吴说道，该研究结果确实是个好消息。他本人并不喜欢给小孩们应用可待因来治疗疼痛，因为“它使孩子们昏昏沉沉”。
当孩子们再因急性疼痛来急诊就诊时，该研究结果是否回改变医生们的用药习惯呢？克拉克说：“我希望如此，急性疼痛是所有各科医生和小儿急诊医生极其常见的疾病。”
克拉克在文章中写道，在他从事该研究的小儿科，约10%的就诊患者属于这些肌肉骨骼损伤。
专家对受伤孩子们父母的最终建议说，就诊回家后父母最好还是应用布洛芬。对于那些肌肉骨骼损伤不太严重而无需前来就诊的孩子们也是如此。
该研究发表在《儿科杂志》三月份刊上。
是不是也适合成人？
