Comparison of Intravenous Ketorolac, Meperidine, and Both (Balanced Analgesia) for Renal Colic

Cordell, William H.; Wright, Seth W.; Wolfson, Allan B.; Timerding, Beverly L; Maneatis, Thomas; Lewis, Reina; Bynum, Lincoln J.; Nelson, David R.

doi:10.1016/s0196-0644(96)70055-0

Cited by 78 publications

(61 citation statements)

References 29 publications

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“…Prospective randomized controlled studies suggest that NSAIDs are at least as effective as opiates [15,16].…”

Section: Discussionmentioning

confidence: 99%

Diclofenac versus Tramadol in the Treatment of Renal Colic: A Prospective, Randomized Trial

Salameh¹

2011

TOEMJ

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Abstract:Objective: Nonsteroidal anti-inflammatory drugs are considered the mainstay in the treatment of renal colic. Nonsteroidal anti-inflammatory drugs are contraindicated in patients with renal failure and are not recommended in patients with certain diseases. In these cases other analgesics should be used. The aim of our study was to compare the analgesic efficacy of intramuscular Diclofenac and Tramadol in the treatment of renal colic in our emergency department.Methods: A prospective, randomized trial was conducted in patients with a clinical picture of renal colic. Diagnosis was confirmed by non contrast abdominal computed tomography. Subjects were randomized to receive a single intramuscular injection of either 75 mg Diclofenac or 100 mg Tramadol. Ninety seven patients were included, of these 48 received Diclofenac and 49 received Tramadol.Results: Patients' characteristics including average stone size and degree of hydronephrosis were similar at enrollment. Diclofenac was significantly more effective than Tramadol in reducing the severity of pain at 30 minutes as measured on a 10-cm visual analogue scale. Reduction of more than 50% in pain severity was observed in 64% of patients treated with Diclofenac and in 49% of patients treated with Tramadol (P < 0.05). More patients in the Tramadol group needed rescue analgesia: 51% vs 21(p< 0.05). For all the study variables, Diclofenac was better than Tramadol Conclusions: Intramuscular Diclofenac as a single agent for the treatment of renal colic is more effective than intramuscular Tramadol in our patients. Intramuscular Tramadol may be an alternative when contraindications preclude the use of Diclofenac.

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“…Prospective randomized controlled studies suggest that NSAIDs are at least as effective as opiates [15,16].…”

Section: Discussionmentioning

confidence: 99%

Diclofenac versus Tramadol in the Treatment of Renal Colic: A Prospective, Randomized Trial

Salameh¹

2011

TOEMJ

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“…Tablets (only as continuation of IV form) are also available. Ketorolac has been shown to be more effective than meperidine (narcotic analgesic) in renal colic 83 . Ketorolac carries a boxed FDA warning with total combined duration of oral and injectable use not to exceed 5 days 84 .…”

Section: Ketorolacmentioning

confidence: 99%

Risks associated with drug treatments for kidney stones

York

Borofsky

Lingeman

2015

Expert Opinion on Drug Safety

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“…Based on literature review, mean pain scores were identified for the following painful conditions or procedures: eye drops, blood pressure cuff inflation, venipuncture, intravenous catheter placement, intraoral regional anesthesia, pelvic examination, lumbar puncture, nasogastric tube, fracture, and kidney stone. [16][17][18][19][20][21][22][23] The three-minute educational video was developed that included information identical to the printed brochure. The video included several educational approaches, including physicians speaking to the viewers to present the information and reenactments of painful procedures during the verbal descriptions.…”

Section: Study Protocolmentioning

confidence: 99%

The Verbal Numeric Pain Scale: Effects of Patient Education on Self-reports of Pain

Marco

Plewa

et al. 2006

Acad Emergency Med

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Comparison of Intravenous Ketorolac, Meperidine, and Both (Balanced Analgesia) for Renal Colic

Cited by 78 publications

References 29 publications

Diclofenac versus Tramadol in the Treatment of Renal Colic: A Prospective, Randomized Trial

Diclofenac versus Tramadol in the Treatment of Renal Colic: A Prospective, Randomized Trial

Risks associated with drug treatments for kidney stones

The Verbal Numeric Pain Scale: Effects of Patient Education on Self-reports of Pain

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