Research Article
Prochlorperazine/Diphenhydramine vs Ketorolac for Treatment of Acute-on-Chronic Back Pain Exacerbations in the Emergency Department
Jennifer Stahl, Kori Brewer, William Meggs
Correspondence Address :
Jennifer Stahl
Clinical
Assistant Professor of Emergency Medicine/Internal
Medicine and Critical Care Medicine
East Carolina
University/Brody School of Medicine
USA
Tel: (252) 744-4757
Received on: June 19, 2017, Accepted on: August 04, 2017, Published on: August 11, 2017
Citation: Jennifer Stahl, Kori Brewer, William Meggs (2017). Prochlorperazine/Diphenhydramine vs Ketorolac for Treatment of Acute-on-Chronic Back Pain Exacerbations in the Emergency Department
Copyright: 2017 Jennifer Stahl, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Back pain is one of the most commonly reported chief complaints for Emergency Department visits. Non-narcotic treatment strategies are ideal for this patient population. In this study, we investigate whether treatment with prochlorperazine and diphenhydramine would provide significant pain relief for acute exacerbations of chronic back pain.
Methods: Patients who presented to the ED with a chief complaint of lower back pain and met study criteria were randomized into two arms of treatment. One group received prochlorperazine 10 mg plus diphenhydramine 50 mg intravenously (IV) and the other group received standard of care treatment with ketorolac 30 mg IV. Patients were monitored for relief of symptoms for 1 hour.
Results: In this study, 6 patients were enrolled and received prochlorperazine and diphenhydramine treatment. Pain scores for these patients were: 0 minutes (baseline) mean = 9.5 (95% CI = 8.6-10), 30 minutes mean = 7.3 (95% CI = 5.5-9.2), and 60 minutes mean = 6.7 (95% CI = 4.2-9.1). The change in pain from 0 minutes (baseline) to 30 min was mean = 2.2 (95% CI=0.6-3.7) with p=0.01, and the change from baseline to 60 minutes was mean = 2.8 (95% CI=0.6-5.1) with p<0.01.
Conclusions: Patients who received prochlorperazine and diphenhydramine treatment demonstrated pain relief at 30 minutes that persisted at 60 minutes. Pain was improved at 60 minutes with statistical significance when compared to baseline. This study shows the potential of prochlorperazine and diphenhydramine as a treatment modality for acute exacerbations of chronic back pain.