Abstract | BACKGROUND: METHODS: Medline, Embase, and CENTRAL databases were searched. Randomized controlled trials (RCTs) that compared different analgesic agents, either alone or in combination were included. For the management of acute renal colic, analgesic agents were selected based on the current standard medical practice. The medications included intravenous acetaminophen, ketamine, ketorolac, and morphine. This study sought to evaluate the pain score on the visual analog scale (VAS) at 15, 30, and 60 min; adverse events; and the utilization of rescue therapy. The efficacy of different analgesic agents was explored through a frequentist network meta-analysis using the Netmeta statistical package in R software. All treatments were ranked using the Netrank function, yielding P-scores. RESULTS: Twelve RCTs were deemed eligible. As per the P-scores, acetaminophen was the most effective in reducing pain score at 15 min (P-score = 0.74). Ketorolac was the most effective in reducing the pain score at 30 and 60 min (P-score = 0.84) (P-score = 0.99), whereas morphine was the least effective (P-score = 0.07). Moreover, morphine was correlated with the highest odds of adverse events after treatment (P-score = 0.89). Morphine was the most frequently required rescue therapy in cases of suboptimal pain relief (P-score = 0.96). CONCLUSION:
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Authors | Yasir A Alghamdi, Roaa E Morya, Dena M Bahathiq, Abdullah F Bokhari, Ahmad K Alaboud, Ahmed S Abdulhamid, Abdullah A Ghaddaf, Maan Jamjoom |
Journal | The American journal of emergency medicine
(Am J Emerg Med)
Vol. 73
Pg. 187-196
(Nov 2023)
ISSN: 1532-8171 [Electronic] United States |
PMID | 37679264
(Publication Type: Journal Article)
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Copyright | Copyright © 2023. Published by Elsevier Inc. |