Intravenous paracetamol versus morphine for renal colic in the emergency department: a randomised double-blind controlled trial.

Abstract

OBJECTIVE:

To determine the analgesic efficacy and safety of intravenous single-dose paracetamol versus morphine in patients presenting to the emergency department with renal colic.

METHODS:

A randomised double-blind study was performed to compare the efficacy of intravenous paracetamol (1 g) and 0.1 mg/kg morphine in patients with renal colic. The efficacy of the study drugs was measured by a visual analogue scale and a verbal rating scale at baseline and after 15 and 30 min. The adverse effects and need for rescue medication (1 μg/kg intravenous fentanyl) were also recorded at the end of the study.

RESULTS:

133 patients were eligible for enrolment in the study, with 73 patients included in the final analysis (38 in the paracetamol group and 35 in the morphine group). The mean±SD age of the subjects was 30.2±8.6 years and 51 (70%) were men. The mean reduction in scores at 30 min after study drug administration was 63.7 mm (95% CI 57 to 71) for paracetamol and 56.6 mm (95% CI 48 to 65) for morphine. The difference between pain reduction scores for the two groups at 30 min was 7.1 mm (95% CI -18 to 4), demonstrating no statistical or clinical significance. Two adverse events (5.3%) were recorded in the paracetamol group and five (14.3%) in the morphine group (difference 9%, 95% CI -7% to 26%).

CONCLUSION:

Intravenous paracetamol is effective in treating patients presenting with renal colic to the emergency department. CLINICAL TRIALS REGISTRATION NO: ClinicalTrials.gov ID number NCT01318187.

• Authors: Mustafa Serinken, Cenker Eken, Ibrahim Turkcuer, Hayri Elicabuk, Emrah Uyanik, Carl H Schultz
• Journal: Emergency medicine journal : EMJ (Emerg Med J) Vol. 29 Issue 11 Pg. 902-5 (Nov 2012) ISSN: 1472-0213 [Electronic] England
• PMID: 22186009 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Analgesics, Non-Narcotic
• Analgesics, Opioid
• Acetaminophen
• Morphine

Topics

• Acetaminophen (administration & dosage, adverse effects)
• Adolescent
• Adult
• Analgesics, Non-Narcotic (administration & dosage, adverse effects)
• Analgesics, Opioid (administration & dosage, adverse effects)
• Double-Blind Method
• Emergency Service, Hospital
• Female
• Humans
• Injections, Intravenous
• Male
• Middle Aged
• Morphine (administration & dosage, adverse effects)
• Pain Measurement
• Prospective Studies
• Renal Colic (drug therapy)
• Young Adult