Ketoprofen versus Diclofenac sodium in the treatment of renal colic.
Keywords:
Nonsteroidal anti-inflammatory, renal colic, diclofenac, ketoprofen.Abstract
Introduction: Adult renal colic is a frequent lombo-abdominal painful syndrome in emergencies. Treatment is based on nonsteroidal anti-inflammatory drug (NSAID) but the choice between different NSAIDs remains a subject of controversy. Our aim was to compare the efficacy and the safety of two intramuscularly NSAIDs in renal colic.
Methods: We conducted a 32-week, randomized, double-blind, single-center study . Patients who had renal colic with a visual analogue scale (VAS) ≥ 5 were randomly assigned to receive, by intramuscularly injection, 100 mg of Ketoprofen (GK) or 75 mg of diclofenac (GD). If VAS > 3 after 40 minute, 1 g of paracetamol was administered as rescue analgesia. Primary endpoint was successful treatment. Secondary outcome was the occurrence of side effects.
Results: We have included 80 patients. the average age was 39 ± 13 years for GK versus 43 ± 14 years for GD. The mean VAS on admission was also similar in both arms. We objectified a therapeutic success rate of 92% in both groups. This success was similar in both arms. The use of rescue medication was 32.5% in the GK versus 47.5% in the GD (P=0.17). We have observed in 46% (n =37) of the study population side effects. These effects were only minor and no major intolerance expression was registered.
Conclusion: the efficacy and tolerance of NSAIDs in the treatment of renal colic was the same for diclofenac and ketoprofen.
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References
Cordell WH, Keen KK, Giles BK. The high prevalence of pain in emergency Medical care. Am J Emerg Med.2002; 20: 1659.
Cordell W H, Wright S W, Wolfson A B, Timerding B L, Maneatis T J, Lewis R H et al. Renal colic. Ann Emerg Med.1996; 27:451 -3.
Labrecque M, Dostaler L P, Rousselle R, Nguyen T, Poirier S. Efficacy of nonsteroidal antiinflammatory drugs in the treatment of acute renal colic. A meta-analysis. Arch Intern Med. 1994; 154:1381 -7
Holdgate A, Pollock T. Non-steroidal anti-inflammatory drugs (NSAIDS) versus opioids for acute renal colic. Cochrane Database Syst Rev. 2005; 2:CD004137.
Holdgate. A, Pollock. T (2004). Systematic review of the relative efficacy of non-steroidal antiin flammatory drugs and opioids in the treatment of acute renal colic. British Medical Journal, 328(7453), 1401. doi:10.1136/bmj.38119.581991.55
P Ng, CW Kam, HH Yau. A comparison of Ketoprofen and Diclofenac for acute musculoskeletal pain relief: a prospective randomised clinical trial. Hong Kong j.emerg.med. 2001 ; 8: 73-77.
P. T. Jamdade, A. Porwal, J. V. Shinde et al. “Efficacy and tolerability of intramuscular dexketoprofen in postoperative pain management following hernia repair surgery,” Anesthesiology Research and Practice, vol. 2011, 4 pages, 2011.
Niemi L, Tuominen M, Pitkanen M, et al. Comparison of parenteral diclofenac and ketoprofen for postoperative pain relief after maxillofacial surgery. Acta Anaesthesiol Scand 1995 ; 39(1) :96-9.
Kostamovaara PA, Hendolin H, Kokki H, et al. Ketorolac, diclofenac and ketoprofen are equally efficacious for pain relief after total hip replacement surgery. Br J Anaesth 1998; 81(3):369-72.
M. J. B. Rodr´ıguez, R. M. Antonijoan Arb´ os, and S. R. Amaro. Dexketoprofen trometamol: clinical evidence supporting its role as a painkiller,” Expert Review of Neurotherapeutics, vol. 8, no. 11, pp. 1625-1640, 2008.
M. S. Hardikar, “Chiral non-steroidal anti-inflammatory drugs—a review,” Journal of the Indian Medical Association, vol. 106, no. 9, pp. 615-624, 2008. )
Cohen E, Hafner R, Rotenberg Z, et al. Comparison of ketorolac and diclofenac in the treatment of renal colic. Eur J Clin Pharmacol 1998 ; 54(6) :455-8.
Lange R, Lentz R. Comparison ketoprofen, ibuprofen and naproxen sodium in the treatment of tensiontype headache. Drugs Exp Clin Res 1995 ; 21(3) :89-96.
Dash, A., Maiti, R., Akantappa Bandakkanavar, T. K., Arora, P. (2012). Intramuscular drotaverine and diclofenac in acute renal colic: A comparative study of analgesic efficacy and safety. Pain Medicine, 13(3), 466-471. doi:10.1111/j.1526-4637.2011.01314.x.
AC Kennedy, B. J. Mullen, SH Roth, BF Germain, RA Bonebrake, N Wei et al. A double-blind comparison of the efficacy and safety of ketoprofen extended-release (200 MG once daily) and Diclofenac (75 MG twice daily) for treatment of osteoarthritis. Current therapeutic research. Vol. 55, NO. 2, February 1994.
