Intravenous paracetamol vs ibuprofen in renal colic: a randomised, double-blind, controlled clinical trial
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Pain management is one of the essentials of emergency care. Renal colic secondary to urinary stone disease forms one of the most intense pain types. The present study aimed to compare the effect of intravenous ibuprofen to paracetamol in ceasing renal colic. This randomised double-blind study was composed of two intervention arms, intravenous paracetamol and intravenous ibuprofen. Study subjects were randomised to receive a single dose of either paracetamol, 1 g in 100 ml normal saline, or ibuprofen (800 mg in 100 ml normal saline) in a blinded fashion. Subjects reported pain intensity on a visual analogue scale with lines intersection multiples of ten just before the drug administration, 15 and 30 min after the study drug administration. Two hundred patients were randomised to either of two study arms: however, 97 patients in ibuprofen group and 99 patients in paracetamol groups were included into 30 minute analysis. Differences of pain improvements between two groups was 9.5 (5.4–13.7) at 15 min (p = 0.000) and 17.1 (11.9–22.5) at 30 min, those both favouring ibuprofen over paracetamol (p = 0.000). Although ten (10.1%) patients in paracetamol group needed rescue drug, there were only two (2%) patients in ibuprofen group (difference: 8%; 95% CI 0.7–16%, p = 0.02). Intravenous 800 mg ibuprofen is more effective than IV paracetamol in ceasing renal colic at 30 min.
KeywordsParacetamol Ibuprofen Renal colic Treatment Emergency department
Compliance with ethical standards
This study received no industrial funding. The expenditure of the drugs was covered by the Pamukkale University.
Conflict of interest
There are no competing interests. M. Serinken, declares that he has no conflict of interest. C. Eken, declares that he has no conflict of interest. E. Uyanık, declares that he has no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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