Efficacy of ketorolac tromethamine versus meperidine in the ED treatment of acute renal colic.

Abstract

To compare the efficacy of intramuscular ketorolac and meperidine in the emergency department (ED) treatment of renal colic, a prospective, controlled, randomized, double-blind trial was conducted in an academic ED with 76,000 annual visits. Participants were volunteer ED patients with a diagnosis of ureterolithiasis confirmed by intravenous pyelogram. Subjects were randomized 1:1 to receive a single intramuscular injection of either 60 mg ketorolac or 100 to 150 mg meperidine, based on weight. Of the 70 patients completing the trial, 33 received ketorolac and 37 received meperidine. Demographic characteristics and baseline pain scores of both groups were comparable (P = NS, Mann Whitney U). Ketorolac was significantly (P < .05) more effective than meperidine in reducing renal colic at 40, 60, and 90 minutes as measured on a 10-cm visual analogue scale. Similar proportions of patients in each group were given rescue analgesia and admitted. Of patients who were discharged home without rescue, those treated with ketorolac left the ED significantly earlier than those treated with meperidine (3.46 v 4.33 h, P < .05). These results show that intramuscular ketorolac as a single agent for renal colic is more effective than meperidine and promotes earlier discharge of renal colic patients from the ED.

• Authors: G L Larkin, W F Peacock 4th, S M Pearl, G A Blair, F D'Amico
• Journal: The American journal of emergency medicine (Am J Emerg Med) Vol. 17 Issue 1 Pg. 6-10 (Jan 1999) ISSN: 0735-6757 [Print] United States
• PMID: 9928687 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Analgesics, Non-Narcotic
• Analgesics, Opioid
• Tromethamine
• Ketorolac Tromethamine
• Meperidine
• Tolmetin
• Ketorolac

Topics

• Acute Disease
• Adult
• Aged
• Aged, 80 and over
• Analgesics, Non-Narcotic (therapeutic use)
• Analgesics, Opioid (therapeutic use)
• Colic (diagnosis, drug therapy)
• Double-Blind Method
• Emergency Treatment (methods)
• Female
• Humans
• Ketorolac
• Ketorolac Tromethamine
• Male
• Meperidine (therapeutic use)
• Middle Aged
• Pain Measurement
• Prospective Studies
• Time Factors
• Tolmetin (analogs & derivatives, therapeutic use)
• Tromethamine (analogs & derivatives)
• Ureteral Calculi (diagnosis, drug therapy)
• Urography