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Urolithiasis

, Volume 46, Issue 4, pp 369–373 | Cite as

Intravenous paracetamol vs ibuprofen in renal colic: a randomised, double-blind, controlled clinical trial

  • E. Cenker
  • M. SerinkenEmail author
  • E. Uyanık
Original Paper

Abstract

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.

Keywords

Paracetamol Ibuprofen Renal colic Treatment Emergency department 

Notes

Compliance with ethical standards

Funding

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.

Ethical approval

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

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Turkcuer I, Serinken M, Karcioglu O, Zencir M, Keysan MK (2010) Hospital cost analysis of management of patients with renal colic in the emergency department. Urol Res 38(1):29–33CrossRefPubMedGoogle Scholar
  2. 2.
    Gülen B, Oktay C, Akpinar G, Sönmez E (2016) The utility of a standardized evaluation form for complaints in patients with acute abdominal and flank pain. Eurasian J Emerg Med 15:20–23CrossRefGoogle Scholar
  3. 3.
    Serinken M, Eken C, Erdemir F, Eliçabuk H, Başer A (2016) The reliability of national videos related to the kidney stones on YouTube. Turk J Urol 42(1):7–11CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Serinken M, Eken C, Turkcuer I, Elicabuk H, Uyanik E, Schultz CH (2012) Intravenous paracetamol versus morphine for renal colic in the emergency department: a randomised double-blind controlled trial. Emerg Med J 29(11):902–905CrossRefPubMedGoogle Scholar
  5. 5.
    Bektas F, Eken C, Karadeniz O, Goksu E, Cubuk M, Cete Y (2009) Intravenous paracetamol or morphine for the treatment of renal colic: a randomized, placebo-controlled trial. Ann Emerg Med 54(4):568–574CrossRefPubMedGoogle Scholar
  6. 6.
    Pathan SA, Mitra B, Straney LD, Afzal MS, Anjum S, Shukla D, Morley K, Hilli SA, Rumaihi KA, Thomas SH, Cameron PA (2016) Delivering safe and effective analgesia for management of renal colic in the emergency department: a double-blind, multigroup, randomised controlled trial. Lancet. doi: 10.1016/S0140-6736(16)00652-8 CrossRefPubMedGoogle Scholar
  7. 7.
    Southworth SR, Woodward EJ, Peng A, Rock AD (2015) An integrated safety analysis of intravenous ibuprofen [Caldolor(®)] in adults. J Pain Res 8:753–765PubMedPubMedCentralGoogle Scholar
  8. 8.
    Bergese SD, Candiotti K, Ayad SS, Soghomonyan S, Gan TJ (2015) The shortened infusion time of intravenous ibuprofen part 1: a multicenter, open-label, surveillance trial to evaluate safety and efficacy. Clin Ther 37(2):360–367CrossRefPubMedGoogle Scholar
  9. 9.
    Gan TJ, Candiotti K, Turan A et al (2015) The shortened infusion time of intravenous ibuprofen, part 2: a multicenter, open-label, surgical surveillance trial to evaluate safety. Clin Ther 37(2):368–375CrossRefPubMedGoogle Scholar
  10. 10.
    Southworth S, Peters J, Rock A, Pavliv L (2009) A multicenter, randomized, double-blind, placebo-controlled trial of intravenous ibuprofen 400 and 800 mg every 6 h in the management of postoperative pain. Clin Ther 31(9):1922–1935CrossRefPubMedGoogle Scholar
  11. 11.
    Kroll PB, Meadows L, Rock A, Pavliv L (2011) A multicenter, random-ized, double-blind, placebo-controlled trial of intravenous ibuprofen (iv-ibuprofen) in the management of postoperative pain following abdominal hysterectomy. Pain Pract 11(1):23–32CrossRefPubMedGoogle Scholar
  12. 12.
    Kaye AD, Baluch A, Scott JT (2010) Pain management in the elderly population: a review. Ochsner J 10(3):179–187PubMedPubMedCentralGoogle Scholar
  13. 13.
    Serinken M, Eken C, Gungor F, Emet M, Al B (2016) Comparison of intravenous morphine vs paracetamol in sciatica: a randomized placebo controlled trial. Acad Emerg Med. doi: 10.1111/acem.12956 CrossRefPubMedGoogle Scholar
  14. 14.
    Turkcuer I, Serinken M, Eken C, Yilmaz A, Akdag Ö, Uyan E, Kiray C, Elicabuk H (2014) Intravenous paracetamol versus dexketoprofen in acute migraine attack in the emergency department: a randomised clinical trial. Emerg Med J 31(3):182–185CrossRefPubMedGoogle Scholar
  15. 15.
    Eken C, Serinken M, Elicabuk H, Uyanik E, Erdal M (2014) Intravenous paracetamol versus dexketoprofen versus morphine in acute mechanical low back pain in the emergency department: a randomised double-blind controlled trial. Emerg Med J 31(3):177–181CrossRefPubMedGoogle Scholar
  16. 16.
    Golembiewski J, Mueller M (2011) Intravenous acetaminophen. J Perianesth Nurs 26(2):116–119CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  1. 1.Department of Emergency Medicine, Akdeniz University Hospital Medical FacultyAkdeniz University HospitalAntalyaTurkey
  2. 2.Department of Emergency Medicine, Pamukkale University Hospital Medical FacultyPamukkale University HospitalDenizliTurkey

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