Comparing intranasal ketamine with intravenous fentanyl in reducing pain in patients with renal colic: A double-blind randomized clinical trial.

Abstract

BACKGROUND:

Kidney stones are a fairly common problem that manifests itself as symptoms of acute abdominal and flank pains in patients presenting to emergency departments.

OBJECTIVE:

The present study was conducted to compare the analgesic effect of intravenous fentanyl with that of intranasal ketamine in renal colic patients.

METHODS:

One mg/kg of intranasal ketamine was administered in the first group, and one μg/kg of intravenous fentanyl in the second group. The pain severity was measured in the patients in terms of a visual analogue scale (VAS) score at the beginning of the study and at minutes 5, 15 and 30, and the medication side-effects were evaluated and recorded.

RESULTS:

A total of 130 patients were ultimately assessed in two groups of 65. In the ketamine group, the mean severity of pain was 8.72 ± 1.52 at the beginning of the study (P < 0.001), 5.5 ± 2.97 at minute 5 (P < 0.001), 3.38 ± 3.35 at minute 15 (P = 0.004) and 2.53 ± 3.41 at minute 30 (P = 0.449). In the fentanyl group, this severity was 9.66 ± 88.8 in the beginning of the study (P < 0.001), 7.27 ± 1.37 at minute 5 (P < 0.001), 4.61 ± 1.5 at minute 15 (P = 0.004) and 1.24 ± 1.25 at minute 30 (P = 0.449). The general prevalence of the medication side-effects was 10 (15.4%) in the ketamine group and 1 (1.5%) in the fentanyl group (P = 0.009).

CONCLUSIONS:

Ketamine was found to be less effective than fentanyl in controlling renal colic-induced pain, and to be associated with a higher prevalence of side-effects; nevertheless, ketamine can be effective in controlling this pain in conjunction with other medications.

• Authors: Javad Mozafari, Mohammadreza Maleki Verki, Hassan Motamed, Alireza Sabouhi, Fatemeh Tirandaz
• Journal: The American journal of emergency medicine (Am J Emerg Med) Vol. 38 Issue 3 Pg. 549-553 (03 2020) ISSN: 1532-8171 [Electronic] United States
• PMID: 31155169 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2019 Elsevier Inc. All rights reserved.

Chemical References

• Anesthetics, Dissociative
• Anesthetics, Intravenous
• Ketamine
• Fentanyl

Topics

• Administration, Intranasal
• Adult
• Anesthetics, Dissociative (administration & dosage)
• Anesthetics, Intravenous (administration & dosage)
• Double-Blind Method
• Female
• Fentanyl (administration & dosage)
• Humans
• Ketamine (administration & dosage)
• Male
• Middle Aged
• Pain Management (methods)
• Pain Measurement
• Renal Colic (drug therapy)
• Treatment Outcome