A COMPARISON OF INTRAMUSCULAR KETEROLAC AND PETHIDINE IN THE ALLEVIATION OF RENAL COLIC

Objective To compare the analgesic efficacy of a single 30 mg intramus cular dose of ketorolac with that of intramuscular pethidine 100 mg, i n a double-blind, parallel-group investigation of patients presenting with pain suggestive of renal colic. Patients and methods Seventy-six patients (17 women, 15 men; mean age 45.2 years, range 20-80) were all ocated by means of a pre-determined randomization schedule to receive ketorolac and 78 patients (20 women, 58 men; mean age 42.1, years rang e 18-70) to receive pethidine. Data from eight patients in the ketorol ac group and six in the pethidine group were excluded from the efficac y analyses because of protocol violations. The severity of each patien t's pain was assessed on a four-point verbal rating scale (VRS) and a 10 cm visual analogue scale at pre-dose and at 15 min intervals for th e first hour post dosing. The time to first administration of rescue a nalgesic, up to 24 h following dosing with the study medication, was r ecorded. Adverse events were elicited by general questioning. Results Eighty-eight per cent of patients in each treatment group had improved according to the VRS of pain severity 1 h after dosing; the summed pa in intensity differences up to 1 h were statistically significantly di fferent in favour of ketorolac (P < 0.05). Fifty-six per cent of patie nts who were receiving ketorolac required rescue analgesia during the study period compared with 74% receiving pethidine. The incidences of adverse events were lower in the ketorolac group (28%) than the pethid ine group (51%). Conclusion Ketorolac can be considered a viable alter native to pethidine for the treatment of renal colic.