Prophylactic acetaminophen or ibuprofen result in equivalent acute mountain sickness incidence at high altitude: a prospective randomized trial
Autor: | Jared L. Velgersdyk, Aditya Tiwari, Catherine J. O’Leary, Ghan Bahadur Thapa, Thomas F. Freeman, Matiram Pun, Linda E. Keyes, Alicia L. Peterson, Katherine E. Stuart, Dana R. Levin, Peter S. Holck, Ken Zafren, Nicholas C. Kanaan, Bikash Basyal, Buddha Basnyat, Jennifer Starling, Jessica R. Gehner |
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Jazyk: | angličtina |
Rok vydání: | 2017 |
Předmět: |
Adult
Male Adolescent Analgesic Ibuprofen Altitude Sickness law.invention 03 medical and health sciences 0302 clinical medicine Double-Blind Method Nepal Randomized controlled trial law Surveys and Questionnaires medicine Humans Prospective Studies 030212 general & internal medicine Prospective cohort study Acetaminophen Aged business.industry Incidence (epidemiology) organic chemicals Public Health Environmental and Occupational Health 030208 emergency & critical care medicine Middle Aged Effects of high altitude on humans Mountaineering Treatment Outcome Nociception Anesthesia Emergency Medicine Female business medicine.drug |
Zdroj: | Wilderness and Environmental Medicine. 28(2) |
ISSN: | 1080-6032 |
Popis: | Objective Recent trials have demonstrated the usefulness of ibuprofen in the prevention of acute mountain sickness (AMS), yet the proposed anti-inflammatory mechanism remains unconfirmed. Acetaminophen and ibuprofen were tested for AMS prevention. We hypothesized that a greater clinical effect would be seen from ibuprofen due to its anti-inflammatory effects compared with acetaminophen’s mechanism of possible symptom reduction by predominantly mediating nociception in the brain. Methods A double-blind, randomized trial was conducted testing acetaminophen vs ibuprofen for the prevention of AMS. A total of 332 non-Nepali participants were recruited at Pheriche (4371 m) and Dingboche (4410 m) on the Everest Base Camp trek. The participants were randomized to either acetaminophen 1000 mg or ibuprofen 600 mg 3 times a day until they reached Lobuche (4940 m), where they were reassessed. The primary outcome was AMS incidence measured by the Lake Louise Questionnaire score. Results Data from 225 participants who met inclusion criteria were analyzed. Twenty-five participants (22.1%) in the acetaminophen group and 18 (16.1%) in the ibuprofen group developed AMS (P = .235). The combined AMS incidence was 19.1% (43 participants), 14 percentage points lower than the expected AMS incidence of untreated trekkers in prior studies at this location, suggesting that both interventions reduced the incidence of AMS. Conclusions We found little evidence of any difference between acetaminophen and ibuprofen groups in AMS incidence. This suggests that AMS prevention may be multifactorial, affected by anti-inflammatory inhibition of the arachidonic-acid pathway as well as other analgesic mechanisms that mediate nociception. Additional study is needed. |
Databáze: | OpenAIRE |
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