Effectiveness of Intravenous Ketorolac versus Intravenous Morphine Sulfate on Pain Control in Patients with Acute Renal Colic: A Phase 3 Randomized Clinical Trial

Abstract

Introduction: Renal colic is an acute syndrome for which relieving the pain is known to be the best treatment. The aim of this randomized clinical trial was comparing the efficacy of intravenous ketorolac with intravenous morphine sulfate in relieving the acute pain of renal colic in patients referred to the emergency department of a tertiary care teaching hospital. Methods: 98 cases were selected via convenience sampling method from patients with a presumptive diagnosis of renal colic admitted in the emergency department of Besat Nahaja hospital of Tehran, Iran from March to May 2014 and randomly divided into two groups of equal size, ketorolac, and morphine sulfate. The patients' vital signs and pain intensity were observed at baseline of the study and after 10, 30, 60, 120 and 180 minutes of drug administration. Patients were also followed for side effects. The areaunder-the-curve (AUC) was used for pain assessment. Data were analyzed in SPSS 19 using T-test, Chi-square test, and Mann-Whitney test at significance level < 0.05. Results: Demographic and clinical characteristics of the two groups were similar before drug administration. Both drugs were equally effective in reducing pain over time (P-value = 0.17). Side effects of treatment with ketorolac, were significantly less than using morphine sulfate. The most common adverse effects caused by morphine sulfate, were dizziness and vomiting while nausea and vomiting were the most frequent side effects of using ketorolac. Conclusions: Findings of this study indicated that ketorolac and morphine sulfate were equally effective in relieving the pain of renal colic, but given the severity of side effects, ketorolac is the preferred drug.