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The efficacy of intradermal sterile water application in severe renal colic: a randomised clinical trial

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Abstract

It is important to do a fast and effective treatment for patients with renal colic pain in emergency departments for both patients’ comfort and clinicians’ patient management. In this study, we aimed primarily to test the efficacy of intradermal sterile water application as a rapid and effective treatment in severe renal colic. This is a single-centre, prospective, randomised controlled trial. Study group consists of patients with severe renal colic related to urolithiasis. Patients were randomly divided into three groups. The first group received only intramuscular diclofenac sodium, the second group received intramuscular diclofenac sodium and intradermal sterile water, and the third group received intramuscular diclofenac sodium together with intravenous fentanyl. Numerical Rating Scale was used to determine the level of pain before and after the treatment at the 1st, 5th, 15th, 30th, 60th and 120th minutes. 95 out of 201 patients with severe renal colic pain randomly divided into 3 groups. The pre-treatment pain severity of the groups was similar (p = 0.228). We found that the decrease in pain intensity was significantly faster in the intradermal sterile water group than the other groups even in the first minute. Percentages of patients who had 50% pain reduction, which is considered as successful treatment, was higher in the intradermal sterile water group (which had 75.9% success rate) in the first 5 min compared to the IM diclofenac sodium group (which had 7.1% success rate) and IV fentanyl group (which had 25% success rate) (p < 0.001). According to the results, pain control was achieved much faster than the other methods with intradermal sterile water injection. All methods were found to be effective in relieving the pain of the patients.

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Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

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Authors and Affiliations

  1. Department of Emergency Medicine, Başakşehir Çam Ve Sakura City Hospital, Istanbul, Turkey

    Mustafa Caner Aykanat

  2. Department of Emergency Medicine, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey

    Mazlum Kılıç & Tuba Cimilli Öztürk

  3. Department of Emergency Medicine, Kartal Dr. Lütfi Kırdar City Hospital, D-100 Güney Yanyol No:47 Cevizli Mevkii, 34865, Kartal, Istanbul, Turkey

    İzzet Ustaalioğlu & Rohat Ak

Authors
  1. Mustafa Caner Aykanat
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  2. Mazlum Kılıç
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  3. Tuba Cimilli Öztürk
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  4. İzzet Ustaalioğlu
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  5. Rohat Ak
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Contributions

MCA: conceptualisation, methodology, investigation, resources, writing—original draft, writing—review and editing, supervision, project administration. MK: conceptualisation, methodology, investigation, writing—original draft. TCÖ: methodology, investigation, writing—original draft, writing—review and editing. İU: investigation, writing—review and editing. RAK: writing—review and editing.

Corresponding author

Correspondence to Rohat Ak.

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The authors declare that they have no conflicts of interest.

Ethical approval

This study was approved by the Ethics Committee of Fatih Sultan Mehmet Education and Research Hospital (ethics committee ruling number: FSMEAH-KAEK 2021/10, date: 28.01.2021).

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Written informed consent was obtained from each patient.

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The principles outlined in the Declaration of Helsinki have been followed.

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Aykanat, M.C., Kılıç, M., Cimilli Öztürk, T. et al. The efficacy of intradermal sterile water application in severe renal colic: a randomised clinical trial. Urolithiasis 51, 121 (2023). https://doi.org/10.1007/s00240-023-01496-6

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  • DOI: https://doi.org/10.1007/s00240-023-01496-6

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