150
renal colic patients who experienced a
pain level of 4 or greater, based on visual analog scale (VAS) at admission time were included.
Pain was scored on a 100 mm VAS (0 = no
pain, 100 = the worst
pain imagined). When patients arrived at ED, a physician would examine the patients and assessed initial
pain score, then filled a questionnaire according to the patient information. Patients were assigned to receive 2.5 mg
morphine sulfate intravenously. We monitored patients' visual analog scale (VAS), and adverse events at different time points (every 15 minutes) for 90 minutes. Additional doses of intravenous
morphine (2.5 mg) were administered if the patient still had
pain. (Max dose: 10 mg). The cumulative dose of
morphine, defined as the total amount of
morphine prescribed to each patient during the 90 minutes of the study, was recorded. Patients were not permitted to use any nonsteroidal anti-inflammatory drugs as coadjuvant
analgesics during the study period. Subjects with inadequate
pain relief at 90 minutes received rescue
morphine and were excluded from the study. The primary end point in this study was
pain relief at 90 minutes, defined as either VAS<40 or decrease of 50% or more as compared to the initial VAS. The secondary objective was to detect the occurrence of adverse effects at any time points in ED.
RESULTS: The studied patients consisted of 104 men and 46 women with the mean age of 43 ±14 years (range, 18 to 75 years). There was no statistically significant difference between the mean age and gender differences in
pain response. Rescue
analgesia at 30 minutes were given in 54.5% receiving
morphine. The average time to painless was 35 minutes. But there were no statistically significant differences between the mean age and gender differences in
pain response (P > 0.05). Older patients responded sooner to
morphine than the young. Most of the patients had a
pain score of 90 -100 (77.3 %) at the beginning that was reduced to 29.4% during the 30 minutes follow up. During the first hour, we found that 94.7% of the patients had no
pain or significant
pain reduction and only 2.1% of the patients still had
pain.
CONCLUSIONS: