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
- Author:
Mehran SOTOODEHNIA
1
;
Mozhgan FARMAHINI-FARAHANI
;
Arash SAFAIE
;
Fatemeh RASOOLI
;
Alireza BARATLOO
Author Information
- Publication Type:Clinical Trial
- Keywords: Acute pain; Blood pressure; Double-blind method; Drug-related adverse reactions; Hospital emergency service; Ketamine; Ketorolac; Pain management; Randomized controlled trial; Renal colic; Urinary calculi
- MeSH: Acute Pain; Blood Pressure; Dihydroergotamine; Dizziness; Double-Blind Method; Drug-Related Side Effects and Adverse Reactions; Emergencies; Emergency Service, Hospital; Humans; Ketamine; Ketorolac; Pain Management; Renal Colic; Urinary Calculi
- From:The Korean Journal of Pain 2019;32(2):97-104
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND: This study was conducted to compare the effectiveness of low-dose ketamine versus ketorolac in pain control in patients with acute renal colic presenting to the emergency department (ED). METHODS: This is a double-blind randomized clinical trial. The initial pain severity was assessed using the numerical rating scale (NRS). Then, ketamine or ketorolac was administered intravenously at a dose of 0.6 mg/kg and 30 mg respectively. The pain severity and adverse drug reactions were recorded 5, 15, 30, 60, and 120 min thereafter. RESULTS: The data of 62 subjects in the ketamine group and 64 patients in the ketorolac group were analyzed. The mean age of the patients was 34.2 ± 9.9 and 37.9 ± 10.6 years in the ketamine and ketorolac group, respectively. There was no significant difference in the mean NRS scores at each time point, except for the 5 min, between the two groups. Despite a marked decrease in pain severity in the ketamine group from drug administration at the 5 min, a slight increase in pain was observed from the 5 min to the 15 min. The rate of adverse drug reactions, including dizziness (P = 0.001), agitation (P = 0.002), increased systolic blood pressure (> 140 mmHg), and diastolic blood pressure (> 90 mmHg) was higher in the ketamine group. CONCLUSIONS: Low dose ketamine is as effective as ketorolac in pain management in patients with renal colic presenting to the ED. However, it is associated with a higher rate of adverse drug reactions.
