Abstract
There is a suggestion that an antidiuretic hormone-induced decrease in diuresis might contribute to the rapid relief of the acute pain in renal colic. This study was designed to evaluate the efficacy of desmopressin nasal spray compared with diclofenac given intramuscularly in patients with acute renal colic. The study included 75 patients randomized into three different groups; group A received desmopressin (40 μg, nasal spray), group B diclofenac (75 mg) intramuscularly and group C, both desmopressin and diclofenac. Pain was assessed using a visual analogue scale (a 10-cm horizontal scale ranging from `no pain' to `unbearable pain') at baseline, 10, 20 and 30 min after administering the treatments. On admission, the pain level was the same in all three groups. At 10 min the pain decreased in all groups to a level that was not significantly different. At 20 min groups B and C had similar mean pain levels (5.8), whereas in group A it was 5.7. At 30 min, groups B and C scored 3.0 and 2.5 respectively, and group A 6.1. All three treatments were equally effective at 10 and 20 min but at 30 min there was a stabilization/slight increase in pain level in group A. In conclusion, these results indicate that desmopressin may be used to treat renal colic either alone or combined, increasing the analgesic effect of other drugs like diclofenac
 Key words: renal colic, intranasal desmopressin, diclofenac
Highlights
Renal colic is caused by an increase in pelvi-ureteric pressure secondary to an obstruction of the urinary tract
The mean response to therapy after 10 and 20 min was similar in the three groups, the response of individual patients showed that groups A and C had a greater proportion of patients with a marked decrease in their pain scores
As in a previous study [1], the administration of an NSAID with desmopressin was very effective in relieving pain, the desmopressin was given before the NSAID and not simultaneously
Summary
Renal colic is caused by an increase in pelvi-ureteric pressure secondary to an obstruction of the urinary tract. This increase in pressure causes a prostaglandins-mediated increase in renal blood flow and a subsequent increase in diuresis which, in turn, further increases intrapelvic pressure. NSAIDs (inhibitors of PG synthesis) have long been used as effective agents in the treatment of renal colic They block other PG-induced effects, such as afferent arteriolar vasodilatation, which causes an increase in diuresis and raises pelvic pressure. They reduce local oedema and inflammation, and inhibit the stimulation of ureteric smooth muscle, which is responsible for increased peristalsis and subsequently increased ureteric pressure. There is a suggestion that an ADH-induced decrease in diuresis might
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Schedule a callMore From: Iraqi Journal of Pharmaceutical Sciences ( P-ISSN: 1683 - 3597 , E-ISSN : 2521 - 3512)
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