Assessment of Clinical Efficacy of Intranasal Desmopressin Spray and Diclofenac Sodium Suppository in Treatment of Renal Colic Versus Diclofenac Sodium Alone

Roshani, Abdolreza; Falahatkar, Siavash; Khosropanah, Iradj; Roshan, Zahra Atrkar; Zarkami, Tahmineh; Palizkar, Maryam; Emadi, Seyedeh Atefeh; Akbarpour, Marzieh; Khaki, Pejvak

doi:10.1016/j.urology.2008.05.053

Cited by 20 publications

(13 citation statements)

References 19 publications

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“…The mechanism by which desmopressin relieves acute renal colic pain was described in the introduction [9] [10].…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of the Clinical Efficacy of Intranasal Desmopressin Spray, Parenteral Diclofenac or Their Combination in the Treatment of Acute Renal Pain Caused by Urolithiasis

Al-Dabbagh¹,

Kadhum²,

Alfaiadh³

2017

OJU

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Objectives: To evaluate the efficacy of intranasal desmopressin compared with intramuscular diclofenac and combination of both in the treatment of acute renal pain caused by stone disease. Patients and methods: Ninety patients (51 males and 39 females) presented to our hospital emergency department (Al-Yarmouk Teaching Hospital/Baghdad/Iraq) with the diagnosis of acute renal pain caused by urolithiasis. They were randomized into three equal groups; group A received desmopressin 40 μg intranasally (4 puffs, each puff equivalent to 10 micrograms), group B received intramuscular diclofenac 75 mg and group C received both desmopressin and diclofenac.

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“…The mechanism by which desmopressin relieves acute renal colic pain was described in the introduction [9] [10].…”

Section: Discussionmentioning

confidence: 99%

“…At the peripheral level, desmopressin may alleviate the acute renal colic through its potent antidiuretic effect or by relaxing the renal pelvic and ureteral smooth muscles. The central analgesic effect of desmopressin by stimulating the release of the hypothalamic β-endorphins is proposed [9] [10].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Clinical Efficacy of Intranasal Desmopressin Spray, Parenteral Diclofenac or Their Combination in the Treatment of Acute Renal Pain Caused by Urolithiasis

Al-Dabbagh¹,

Kadhum²,

Alfaiadh³

2017

OJU

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“…Considering that COX‐II expression may be increased during ureteric obstruction and renal colic, inhibitors of COX‐II may be particularly suitable for the treatment of renal colic [9]. The result from randomised controlled trials has suggested that parenteral NSAIDs are as effective as narcotics in treading renal colic [3]. Spasmolytic drugs may be an attractive alternative to opioids and NASIDs because they potentially act directly on the contracted ureter, and they have none of the side‐effects of the other classes of drugs.…”

Section: Discussionmentioning

confidence: 99%

“…The high level of prostaglandins is also implicated in the development of oedema around the stone and a reduction in smooth muscle activity in the renal pelvis and ureter [2]. NSAIDs have been used in the treatment of renal colic for several years [3]. These drugs block prostaglandins‐induced effects, such as an afferent arteriolar vasodilatation, which causes an increase in diuresis and consequently raises pelvic pressure.…”

Section: Introductionmentioning

confidence: 99%

Treatment of loin pain suspected to be renal colic with papaverine hydrochloride: a prospective double‐blind randomised study

et al. 2012

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Study Type – Therapy (RCT) Level of Evidence 1b What's known on the subject? and What does the study add? Results of our study showed that intravenous papaverine hydrochloride plus suppository sodium diclofenac were more effective than diclofenac sodium suppository alone in the treatment of acute renal colic. Therefore, intravenous papaverine hydrochloride may be a beneficial supplemental therapy to relieve renal colic pain, particularly in combination with NSAIDs. OBJECTIVE To assess the efficacy of papaverine hydrochloride combined with a diclofenac sodium suppository to relieve renal colic compared with diclofenac suppository monotherapy, as the effect of phosphodiesterase inhibitors on ureteric muscles might reduce the pain of renal colic. PATIENTS AND METHODS A prospective, double‐blind clinical study was performed. In all, 550 patients aged 17–55 years with acute renal colic were randomised to two groups. Patients in one group (group A) received a diclofenac suppository (100 mg) plus saline 0.9% (placebo) and the other group (group B) received a diclofenac suppository (100 mg) plus intravenous (i.v.) papaverine hydrochloride (1.5 mg/kg up to120 mg). Pain intensity was assessed using a visual analogue scale (VAS) at 0, 20 and 40 min after treatment. Further analgesia was provided at the patients' request (25 mg pethidine intramuscularly). RESULTS Baseline characteristics (sex, age, past history of similar pains) were similar in the two groups. There were significant differences in VAS pain scores between 0 and 20 min and 0 and 40 min in both groups (P < 0.001). At the end of study, 71.1% of patients in group A and 90.9% of patients in group B reported pain relief and did not require pethidine, respectively. Significantly more patients in group A required further analgesia. CONCLUSIONS According to our results, i.v. papaverine hydrochloride plus a diclofenac suppository were more effective than the diclofenac suppository alone for treating acute renal colic. Therefore, i.v. papaverine hydrochloride is a beneficial supplemental therapy to relieve renal colic pain, particularly combined with non‐steroidal anti‐inflammatory drugs.

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“…The most frequent drug, which is used, is injectable sodium diclofenac. Its peak plasma concentration is 10–22 minutes after administration [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

The Efficacy of Intranasal Desmopressin as an Adjuvant in the Acute Renal Colic Pain Management

Masoumi

Darian

Forouzan

et al. 2014

Pain Research and Treatment

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The aim of this study was to compare analgesic effect of intramuscular (IM) sodium diclofenac and intranasal desmopressin combination with IM sodium diclofenac alone in patients with acute renal colic. In this randomized double-blind clinical trial, all patients aged 18 to 55 years who were diagnosed as acute renal colic and met the inclusion and exclusion criteria were randomized into two groups to receive 40 μg intranasal desmopressin spray and 75 mg IM sodium diclofenac combination (Group A) or 75 mg IM sodium diclofenac alone (Group B). The pain score of patients was assessed using a visual analogue scale (VAS) at baseline, 15, 30, 45, and 60 minutes after administration. Of all 159 patients who were assessed for eligibility finally, the results of 120 patients were analyzed. There was no significant difference regarding age and gender between two groups. The baseline VAS score was not significantly different between two groups (P = 0.44). The Mean ± SD scores of two groups reduced 15 minutes after drug administration, but this decrease was significantly more in Group A compared with Group B (P = 0.02). This pattern continued in minutes 30, 45, and 60 of drug administration. Our results showed that desmopressin could be used as an effective adjuvant in acute renal colic pain management.

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Assessment of Clinical Efficacy of Intranasal Desmopressin Spray and Diclofenac Sodium Suppository in Treatment of Renal Colic Versus Diclofenac Sodium Alone

Cited by 20 publications

References 19 publications

Evaluation of the Clinical Efficacy of Intranasal Desmopressin Spray, Parenteral Diclofenac or Their Combination in the Treatment of Acute Renal Pain Caused by Urolithiasis

Evaluation of the Clinical Efficacy of Intranasal Desmopressin Spray, Parenteral Diclofenac or Their Combination in the Treatment of Acute Renal Pain Caused by Urolithiasis

Treatment of loin pain suspected to be renal colic with papaverine hydrochloride: a prospective double‐blind randomised study

The Efficacy of Intranasal Desmopressin as an Adjuvant in the Acute Renal Colic Pain Management

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