Paracetamol vs. Intravenous Morphine Plus Diclofenac in Renal Colic Pain: A Randomized Clinical Trial

Abstract

Background: Renal colic is one of the most prevalent diagnoses made in emergency departments. Main medications used to relieve renal colic is opioids and non-steroidal anti-inflammatory drugs (NSAID). As far as these medications may have some side effects, researchers have always focused on proposing analgesics with more efficacy and less side effects. In the present study, it was tried to compare paracetamol and intravenous morphine plus diclofenac in renal colic. Methods: In this single-center double-blinded randomized clinical trial, a total of 180 18 - 65 years old patients with definite diagnosis of renal colic with documented renal system calculus attending emergency department of Emam Reza educational-clinical center, Tabriz-Iran were included. These patients were randomly divided into two control and intervention groups, where the control group received intravenous morphine plus diclofenac and intervention group received intravenous paracetamol. Then, patients’ pain was measured using visual analog scale 0, 10, 20, 30, minutes and 24 hours after administration of medications and compared with each other. In this study, SPSSTM Version 15 was used for statistical analysis. Results: There was no statistically significant difference between the two groups. Difference between patient’s pain severity in intervention and control groups was not statistically significant, however, both groups experienced statistically significant reduction in pain severity from a time stage to another (P< 0.05). Considering side effects, nausea was the only side effect that occurred, which affected 14 patients (15.55%) in the control group, while no side effects were recorded for the intervention group. Conclusions: Based on the present study, paracetamol may be proposed as an effective alternative for routine medications in treatment of renal colic, due to the fact that it has comparable efficacy in pain reduction with opioids and NSAIDs as well as has less side effects.