Evaluation of the effect of oral Ketamine compared to placebo on pain reduction in patients with renal colic: a double-blind randomized clinical trial study

Abstract

Introduction: Renal colic caused by urolithiasis is one of the common causes of severe pain and referral to the emergency room. Using a multimodal method in controlling this type of pain by available anesthetics such as ketamine can help relieve pain, increase satisfaction and reduce hospitalization. Method: This study was conducted as a double-blind clinical trial. 44 patients with renal colic with ASA class 1 were divided into two intervention and control groups. Pethidine (1mg/kg) was administered to both groups. In the intervention group, oral ketamine (0.5 mg/kg) dissolved in 5% dextrose was prescribed, and in the control group, 5% dextrose serum (0.1 ml/kg) was used. Pain intensity was measured by numerical method (NRS) before the treatment and half, one, two and three hours after the intervention. Findings: The median age of the intervention group was 35.2 and the control group was 38.9 (p=0.092). The average amount of pethidine consumed in the intervention group was 94 mg and in the control group was 89 mg, and there was no significant difference between the two groups (p=0.095). In the intervention group, 27.3% and in the control group, 72.7% needed additional pethidine (p=0.000). In hours one, two and three after treatment, the intensity of pain in the intervention group was lower than in the control group, and only in the third hour this difference was statistically significant (p = 0.03). Conclusion: The use of oral ketamine can reduce restlessness without causing side effects and along with pethidine can help relieve the pain of renal colic in the emergency department