Intramuscular Diclofenac Sodium versus Intravenous Baralgin in the Treatment of Renal Colic

Sanahuja, Jaime; Corbera, Gaspar; Garau, Javier; Plà, Ramón; Carré, M. Carmen

doi:10.1177/106002809002400403

Cited by 11 publications

(4 citation statements)

References 5 publications

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“…In the USA, opioids are the primary means of controlling pain in patients with renal colic. However, since the late 1970s, NSAIDs have been widely used outside the USA to treat renal colic and many studies have confirmed their efficacy [ 20–27]. In a recent meta‐analysis, Labrecque et al .…”

Section: Discussionmentioning

confidence: 99%

Piroxicam fast‐dissolving dosage form vs diclofenac sodium

SupervIa¹,

Pedro-Botet²,

Nogués³

et al. 1998

British Journal of Urology

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Objective To assess the possible therapeutic effect of 40 mg sublingual piroxicam (fast‐dissolving dosage form, FDDF) compared with intramuscular 75 mg diclofenac, as a reference drug, on acute renal colic in a randomized, double‐blind controlled clinical trial. Patients and methods Eighty patients were assigned to one of two treatment groups; one received an intramuscular injection with 0.2 mL distilled water and two sublingual tablets of 20 mg piroxicam FDDF, and the other received an intramuscular injection with 75 mg diclofenac sodium and two sublingual tablets of placebo. Pain intensity was evaluated by the patient using a visual analogue scale and by the observers. Vital signs at baseline and 30 min after the administration of the study drugs were also recorded. Results The overall efficacy of the treatment was 81%; nine patients in the piroxicam and six in the diclofenac group (no significant difference) required rescue treatment. Compared with baseline levels, the pain relief was significant (P<0.001) at 30 min in both groups. Twenty‐two patients in the piroxicam and 25 in the diclofenac group attained complete pain relief at 30 min, as evaluated by the observer (no significant difference). Both treatments were similarly effective in decreasing vital signs, mainly systolic blood pressure, heart and respiratory rates. However, when the percentage change was compared between the groups, piroxicam significantly decreased the respiratory rate (P<0.03). Conclusion Piroxicam FDDF is as effective as parenteral diclofenac in emergency renal colic treatment. Furthermore, its ease of self‐administration increases patient compliance and potential use in general practice.

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Section: Discussionmentioning

confidence: 99%

Piroxicam fast‐dissolving dosage form vs diclofenac sodium

SupervIa¹,

Pedro-Botet²,

Nogués³

et al. 1998

British Journal of Urology

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“…Yılmaz ve arkadaşlarının spontan taş pasajına alfa blokörlerin etkisini değerlendirdiği çalışmasında tamsulosin, terazosin, doxazosin'in üçünün de kontrol grubuna göre istatistiksel olarak taş pasajında önemli etkiye sahip olduğu ve daha az analjezik ilaç gereksinimi duyulduğu, ağrı epizotlarını azalttığı bildirilmiştir 48 . Sanahuja ve arkadaşlarının 57 hastayla yaptığı intramuskuler diklofenak sodyum ile dipyron+spazmolitik birleşimi ilacı karşılaştırdığı çalışmada diklofenak daha etkin bulunmuştur 66 . Lopes ve arkadaşlarının renal kolikte intranazal desmopresin ile intramuskuler diklofenak ve desmopresin+diklofenak ilaç gruplarını karşılaştırdığı çalışmada desmopresin'in diklofenak'ın etkinliğini arttırdığını saptamışlardır 67 .…”

Section: Renal Kolik Tıbbi Tedavisine Yönelik Bazı çAlışmalarunclassified

Acil Serviste Renal Kolikli Hasta Yönetimi

Ay¹,

Avcı²,

Acehan³

et al. 2014

Arşiv Kaynak Tarama Dergisi

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Renal colic is a common emergent urological problem seen in emergency departments, which often occurs due to kidney stone disease and characterized by severe pain. Renal colic is described by the patients as the most painful and debilitating experience of their life. The main purpose of emergency treatment is to control pain effectively, and resolve urinary obstruction without causing loss of renal function. In this compilation, studies regarding the management of patients with renal colic in emergency department are reviewed.

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“…However, 37.5% of patients still experienced moderate or severe pain at 15 minutes. 10 Therefore, an effective and available therapy is urgently needed to accelerate pain relief.…”

Section: Introductionmentioning

confidence: 99%

“…In a previous study, Pain alleviation was observed with a mean (SD) of 18.64 (7.99) minutes after intramuscular diclofenac sodium injection. However, 37.5% of patients still experienced moderate or severe pain at 15 minutes . Therefore, an effective and available therapy is urgently needed to accelerate pain relief.…”

Section: Introductionmentioning

confidence: 99%

Effect of Adjunctive Acupuncture on Pain Relief Among Emergency Department Patients With Acute Renal Colic Due to Urolithiasis

Cao

Wang

et al. 2022

JAMA Netw Open

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IMPORTANCE Renal colic is described as one of the worst types of pain, and effective analgesia in the shortest possible time is of paramount importance.OBJECTIVES To examine whether acupuncture, as an adjunctive therapy to analgesics, could accelerate pain relief in patients with acute renal colic. DESIGN, SETTING, AND PARTICIPANTSThis single-center, sham-controlled, randomized clinical trial was conducted in an emergency department in China between March 2020 and September 2020. Participants with acute renal colic (visual analog scale [VAS] score Ն4) due to urolithiasis were recruited. Data were analyzed from October 2020 to January 2022. INTERVENTIONS After diagnosis and randomization, all patients received 50 mg/2 mL of diclofenac sodium intramuscular injection immediately followed by 30-minute acupuncture or sham acupuncture. MAIN OUTCOMES AND MEASURESThe primary outcome was the response rate at 10 minutes after needle manipulation, which was defined as the proportion of participants whose VAS score decreased by at least 50% from baseline. Secondary outcomes included response rates at 0, 5, 15, 20, 30, 45, and 60 minutes, rescue analgesia, and adverse events.RESULTS A total of 115 participants were screened and 80 participants (66 men [82.5%]; mean [SD] age, 45.8 [13.8] years) were enrolled, consisting of 40 per group. The response rates at 10 minutes were 77.5% (31 of 40) and 10.0% (4 of 40) in the acupuncture and sham acupuncture groups, respectively. The between-group differences were 67.5% (95% CI, 51.5% to 83.4%; P < .001). The response rates of acupuncture were also significantly higher than sham acupuncture at 0, 5, 15, 20 and 30 minutes, whereas no significant difference was detected at 45 and 60 minutes. However, there was no difference between the 2 groups in rescue analgesia rate (difference 2.5%; 95% CI −8.8% to 13.2%; P > .99). No adverse events occurred during the trial. CONCLUSIONS AND RELEVANCEThese findings suggest that acupuncture plus intramuscular injection of diclofenac is safe and provides fast and substantial pain relief for patients with renal colic compared with sham acupuncture in the emergency setting. However, no difference in rescue analgesia was found, possibly because of the ceiling effect caused by subsequent but robust analgesia of diclofenac. Acupuncture can be considered an optional adjunctive therapy in relieving acute renal colic.

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Intramuscular Diclofenac Sodium versus Intravenous Baralgin in the Treatment of Renal Colic

Cited by 11 publications

References 5 publications

Piroxicam fast‐dissolving dosage form vs diclofenac sodium

Piroxicam fast‐dissolving dosage form vs diclofenac sodium

Acil Serviste Renal Kolikli Hasta Yönetimi

Effect of Adjunctive Acupuncture on Pain Relief Among Emergency Department Patients With Acute Renal Colic Due to Urolithiasis

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