Comparison of clinical efficacy of intravenous acetaminophen with intravenous morphine in acute renal colic: a randomized, double-blind, controlled trial.

Maryam Feli,Ali Khavanin,Hassan Barzegari,Arash Forouzan,Kambiz Masoumi,Ali Asgari Darian

doi:10.1155/2014/571326

Maryam Feli, Ali Khavanin + Show 4 more

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https://doi.org/10.1155/2014/571326

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Abstract

The aim of this study was to compare the clinical efficacy of intravenous acetaminophen with intravenous morphine in acute renal colic pain management. In this double-blind controlled trial, patients aged 18–55 years, diagnosed with acute renal colic, who met the inclusion and exclusion criteria, were randomized into two groups. First, using the visual analogue scale (VAS), intensity of pain was assessed in both groups. Then, one gram of intravenous acetaminophen or 0.1 mg/kg morphine was infused in 100 mL normal saline to either acetaminophen or morphine group. Intensity of pain was reassessed in 15, 30, 45, and 60 minutes according to VAS criteria. Finally, data from 108 patients were analyzed, 54 patients in each group. No significant difference was observed between the two groups in regard to sex (P = 0.13), mean age (P = 0.54), and baseline visual analogue score (P = 0.21). A repeated measure analysis of variance revealed that the difference between the two treatments was significant (P = 0.0001). The VAS reduction at primary endpoint (30 min after drug administration) was significantly higher in the acetaminophen group than in the morphine group (P = 0.0001). This study demonstrated that intravenous acetaminophen could be more effective than intravenous morphine in acute renal colic patients' pain relief.

Highlights

Pain is the most common chief complaint in emergency departments [1]
Most common drugs used for renal colic pain relief are parenteral opioids and nonsteroidal anti-inflammatory drugs (NSAIDs) [4, 5]
There was a significant difference between two groups in terms of rescue treatment by fentanyl in min 30 (VAS ≥ 5), 31% versus 55% in the acetaminophen group and the morphine group, respectively (P = 0.01)

Summary

Introduction

Pain is the most common chief complaint in emergency departments [1]. The essential duty of all care providers is to relieve or prevent patients’ suffering pain [2]. Renal colic as a result of urolithiasis is a common cause of severe acute pain. Incidence of kidney stone has been increasing in recent years [3]. Renal colic is an acute syndrome of unilateral flank pain, arising from obstruction of urinary tracts. The first action, after ruling out other diagnoses and attention to potential complications, is finding a suitable pain relief technique. Most common drugs used for renal colic pain relief are parenteral opioids and nonsteroidal anti-inflammatory drugs (NSAIDs) [4, 5]

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