Combining 1000 mg oral acetaminophen with 75 mg intramuscular Diclofenac of analgesic efficacy for acute renal colic treatment

Abstract

In this study, we compared oral acetaminophen alone versus intramuscular diclofenac alone versus both together in the treatment of acute renal colic. A prospective, randomized, and double-blind study was conducted in the Emergency Department. Patients were divided into three groups, which were given either acetaminophen + placebo (n = 25), diclofenac sodium + placebo (n = 25) or acetaminophen + diclofenac sodium (n = 25). Pain was evaluated by means of VAS of 100 mm. We monitored patients for visual analog scale (VAS), need for rescue therapy, and adverse events at different time points to at 15, 30 and 60 min. Result of the 183 eligible patients, 75 entered the study. VAS pain scores and demographic data of all three groups were similar before the medical procedure (p > 0.05). No significant differences between VAS pain scores obtained soon after the application of acetaminophen or diclofenac at the 15th, 30th and 60th min were observed (p > 0.05). However, a significant difference in the VAS pain scores of the group to which the combination of acetaminophen + diclofenac was administered was observed compared to the acetaminophen group (p < 0.01). Rescue analgesics at 30 min were required by 6 (24%) subjects receiving acetaminophen, 2 (8%) subjects receiving diclofenac and 2 (8%) subjects receiving combination group. No side effects were detected. The combination of acetaminophen and diclofenac is more effective than acetaminophen alone in patients with renal colic. Orally paracetamol was not effective in treatment renal colic. Key words: Acetaminophen, diclofenac, colic, kidney calculi, emergency treatment.