Lornoxicam with Low-Dose Ketamine versus Pethidine to Control Pain of Acute Renal Colic

Objectives. This study was established to compare single-dose lornoxicam 8 mg (NSAID) in addition to 0.15 mg.kg−1 ketamine with single-dose pethidine 50 mg, both administered intravenously (IV), on the quickness and extent of analgesia, disadvantage, and consequence on utilitarian situation. Patients and Methods. One hundred and twenty patients with acute renal colic pain received in emergency room were included in this prospective, randomized, and double blind clinical study. They were aimlessly designated into one of two groups using a computer-generated table. Group L received lornoxicam 8 mg IV plus 0.15 mg.kg−1 ketamine and Group P received pethidine 50 mg IV. Parameters were noticed at baseline and after 0, 15, 30, and 45 minutes and 1 hour after drug administration. The efficiency of the drug was determined by observing: patient rated pain, time to pain relief, rate of pain recurrence, the need for rescue analgesia, adverse events, and functional status. Results. The visual analogue scale was significantly lower in Group L after 30 minutes in comparison to Group P. In addition, there was statistically significant increase in Group P regarding their need for rescue analgesia after 30 min in comparison to Group L. Group P showed nonsignificantly increased sedation score compared to Group L. Conclusion. Patients receiving lornoxicam-ketamine attained greater reduction in pain scores and less side effects with better functional state and also are less likely to require further analgesia than those administered pethidine to control acute renal colic pain.

Download Full-text

Low-dose intravenous ketamine versus intravenous ketorolac in pain control in patients with acute renal colic in an emergency setting: a double-blind randomized clinical trial

The Korean Journal of Pain ◽

10.3344/kjp.2019.32.2.97 ◽

2019 ◽

Vol 32 (2) ◽

pp. 97-104 ◽

Cited By ~ 3

Author(s):

Mehran Sotoodehnia ◽

Mozhgan Farmahini-Farahani ◽

Arash Safaie ◽

Fatemeh Rasooli ◽

Alireza Baratloo

Keyword(s):

Clinical Trial ◽

Randomized Clinical Trial ◽

Pain Control ◽

Low Dose ◽

Renal Colic ◽

Emergency Setting ◽

Double Blind ◽

Acute Renal Colic ◽

Intravenous Ketamine ◽

Intravenous Ketorolac

Download Full-text

The NARC (Nonsteroidal Anti-inflammatory in Renal Colic) Trial. Single-dose intravenous ketorolac versus titrated intravenous meperidine in acute renal colic: a randomized clinical trial

CJEM ◽

10.1017/s1481803500004656 ◽

2000 ◽

Vol 2 (02) ◽

pp. 83-89 ◽

Cited By ~ 8

Author(s):

Victor M. Wood ◽

James M. Christenson ◽

Grant D. Innes ◽

Mary Lesperance ◽

R. Douglas McKnight

Keyword(s):

Single Dose ◽

Adverse Effects ◽

Functional Status ◽

Renal Colic ◽

Usual Activity ◽

Double Blind ◽

Convenience Sample ◽

Acute Renal Colic ◽

Anti Inflammatory ◽

Primary Hypothesis

ABSTRACTObjectives:Intravenous (IV) opioid titration is an accepted method of relieving acute renal colic. Studies have shown that nonsteroidal anti-inflammatory drugs (NSAIDs) are also effective in this setting. Our objective was to compare single-dose ketorolac and titrated meperidine, both administered intravenously, with respect to speed and degree of analgesia, adverse effects and functional status. Our primary hypothesis was that these agents provide equivalent analgesia within 60 minutes. Our secondary hypotheses were that ketorolac-treated patients would experience fewer adverse effects and would be better able to resume usual activity.Methods:This was a multicentre, double-blind randomized equivalence trial in a convenience sample of patients age 18–65 with moderate or severe renal colic, documented by intravenous pyelogram, ultrasound or stone passage. Meperidine-treated patients received 50 mg IV meperidine at 0 minutes, then 25–50 mg every 15 minutes as needed for ongoing pain. Ketorolac-treated patients received 30 mg IV ketorolac at 0 minutes and placebo injections every 15 minutes as needed. Pain levels and adverse effects were assessed every 15 minutes, and functional status was evaluated at 60 minutes. Our primary outcome was the proportion of patients with mild or no pain at 60 minutes.Results:Overall, 49 of 77 meperidine-treated patients (64%; 95% confidence interval [CI], 53%–75%) and 47 of 65 ketorolac-treated patients (72%; 95% CI, 61%–83%) achieved successful pain relief at 60 minutes (pvalue for equivalence = 0.002). Ten percent of meperidine-treated patients and 44% of ketorolac-treated patients were able to resume usual activity at 60 minutes (p= 0.001).Conclusions:In the doses studied, single-dose IV ketorolac is as effective as titrated IV meperidine for the relief of acute renal colic and causes less functional impairment.

Download Full-text

Low Dose Perioperative Ketamine Infusion and it's Effect on Postoperative Pain Score, Sedation Score and Narcotic Consumption in Patients Undergoing Spine Surgery: A Prospective Randomized Double Blind Control Trial.

Case Medical Research ◽

10.31525/ct1-nct04259476 ◽

2020 ◽

Author(s):

Keyword(s):

Postoperative Pain ◽

Pain Score ◽

Spine Surgery ◽

Low Dose ◽

Sedation Score ◽

Double Blind ◽

Ketamine Infusion ◽

Postoperative Pain Score

Download Full-text

Does lidocaine as an adjuvant to morphine improve pain relief in patients presenting to the ED with acute renal colic? A double-blind, randomized controlled trial

The American Journal of Emergency Medicine ◽

10.1016/j.ajem.2015.11.062 ◽

2016 ◽

Vol 34 (3) ◽

pp. 443-448 ◽

Cited By ~ 20

Author(s):

Abolfazl Firouzian ◽

Abbas Alipour ◽

Hale Rashidian Dezfouli ◽

Alieh Zamani Kiasari ◽

Afshin Gholipour Baradari ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Pain Relief ◽

Renal Colic ◽

Controlled Trial ◽

Double Blind ◽

Randomized Controlled ◽

Acute Renal Colic

Download Full-text

DOUBLE-BLIND, PLACEBO -CONTROLLED COMPARISON OF THERAPEUTIC EFFECT OF MORPHINE AND KETOPROFEN IN MONOTHERAPY AND IN ASSOCIATION VERSUS DESMOPRESSIN FOR ACUTE RENAL COLIC: ABOUT 120 PATIENTS

European Urology Supplements ◽

10.1016/s1569-9056(06)60055-9 ◽

2006 ◽

Vol 5 (2) ◽

pp. 34

Author(s):

S. Ben Rhouma ◽

S. Sallami ◽

I. Bensalah ◽

M. Chelif ◽

G.H. Hafsia ◽

...

Keyword(s):

Therapeutic Effect ◽

Renal Colic ◽

Double Blind ◽

Double Blind Placebo ◽

Acute Renal Colic

Download Full-text

Does Single, Low-Dose Preoperative Dexamethasone Improve Outcomes after Colorectal Surgery Based on an Enhanced Recovery Protocol? Double-Blind, Randomized Clinical Trial

The American Surgeon ◽

10.1177/000313480807400216 ◽

2008 ◽

Vol 74 (2) ◽

pp. 160-167 ◽

Cited By ~ 8

Author(s):

Turkay Kirdak ◽

Aysun Yilmazlar ◽

Sinan Cavun ◽

Ilker Ercan ◽

Tuncay Yilmazlar

Keyword(s):

Colorectal Surgery ◽

Hospital Stay ◽

Interleukin 6 ◽

Low Dose ◽

Postoperative Outcomes ◽

High Dose ◽

C Reactive Protein ◽

Double Blind ◽

Reactive Protein ◽

Pain Scores

Preoperative single, high-dose methylprednisolone administration improves postoperative outcomes after colonic surgery. Several randomized studies, including major surgeries, assessed various high-dose steroid regimens; however, evidence about the effect of administration of lower doses on postoperative outcomes in colorectal surgery is not available. The aim of the present study is to determine whether the administration of a single, low dose of dexamethasone before surgery would confer an outcome advantage after colorectal surgery. Thirty patients undergoing colorectal surgery were included in this randomized, double-blind study. Patients received 8 mg dexamethasone or serum physiologic preoperatively. Levels of Interleukin-6 and C-reactive protein, pain scores, postoperative nausea and vomiting, mobilization, complications, hospital stay, and readmissions were compared. Age, sex, indications, and operations were similar in both groups ( P > 0.05). C-reactive protein and Interleukin-6 levels increased significantly postoperatively in each group ( P < 0.05), but there were no differences between groups when compared ( P > 0.05). There were also no significant differences between pain scores, bowel functions, mobilization, hospital stay, complication rates, and readmission rates between the two groups ( P > 0.05). Preoperative 8 mg dexamethasone administration has no significant effect on reducing postoperative inflammatory response and also does not improve outcomes of colorectal surgery.

Download Full-text

MP-03.02: A double-blind, placebo-controlled comparison of voltaren and tramadol for acute renal colic

Urology ◽

10.1016/j.urology.2007.06.207 ◽

2007 ◽

Vol 70 (3) ◽

pp. 53

Author(s):

H. Ahmadnia ◽

M. Darabi ◽

S. Ghanbarizadeh ◽

M. Molaee ◽

M. Shokohian

Keyword(s):

Renal Colic ◽

Double Blind ◽

Double Blind Placebo ◽

Acute Renal Colic

Download Full-text

Effects of perioperative S (+) ketamine infusion added to multimodal analgesia in patients undergoing ambulatory haemorrhoidectomy

Scandinavian Journal of Pain ◽

10.1016/j.sjpain.2010.01.001 ◽

2010 ◽

Vol 1 (2) ◽

pp. 100-105 ◽

Cited By ~ 5

Author(s):

Ulrich J. Spreng ◽

Vegard Dahl ◽

Johan Ræder

Keyword(s):

Side Effects ◽

Postoperative Analgesia ◽

Analgesic Effect ◽

Low Dose ◽

Isotonic Saline ◽

Multimodal Analgesia ◽

Controlled Study ◽

Double Blind ◽

Pain Scores ◽

Pacu Stay

AbstractBackground and objectivePerioperative low-dose ketamine has been useful for postoperative analgesia. In this study we wanted to assess the analgesic effect and possible side-effects of perioperative low-dose S (+) ketamine when added to a regime of non-opioid multimodal pain prophylaxis.MethodsSeventy-seven patients scheduled for haemorrhoidectomy were enrolled in this randomized, double-blind, controlled study. They received oral paracetamol 1–2 g, total intravenous anaesthesia, intravenous 8 mg dexamethasone, 30 mg ketorolac and local infiltration with bupivacaine/epinephrine. Patients randomized to S (+) ketamine received an intravenous bolus dose of 0.35 mg kg−1 S (+) ketamine before start of surgery followed by continuous infusion of 5 μg kg−1 min−1 until 2 min after end of surgery. Patients in the placebo group got isotonic saline (bolus and infusion). BISTM monitoring was used. Pain intensity and side-effects were assessed by blinded nursing staff during PACU stay and by phone 1, 7 and 90 days after surgery.ResultsIn patients randomized to S (+) ketamine emergence from anaesthesia was significantly longer (13.1 min vs. 9.3 min; p < 0.001). BIS values were significantly higher during anaesthesia (maximal value during surgery: 62 vs. 57; p = 0.01) and when opening eyes (81 vs. 70, p < 0.001). Pain scores (NRS and VAS) did not differ significantly between groups.ConclusionsThe addition of perioperative S (+) ketamine for postoperative analgesia after haemorrhoidectomy on top of multimodal non-opioid pain prophylaxis does not seem to be warranted, due to delayed emergence and recovery, more side-effects, altered BIS readings and absence of additive analgesic effect.

Download Full-text