THE EFFICACY OF SUBLINGUAL HYOSCYAMINE SULFATE AND INTRAVENOUS KETOROLAC TROMETHAMINE IN THE RELIEF OF URETERAL COLIC

A prospective, randomized, open-label, single-dose study was con ducte d in an emergency department (ED) of a tertiary care teaching hospital to evaluate the efficacy of hyoscyamine sulfate as compared to ketoro lac tromethamine for the reduction of pain from ureteral colic in the ED, Patients were included if they were at least 18 years of age and p resented to the ED with an initial history and physical examination co nsistent with ureteral colic. Ureteral calculi were confirmed by ultra sound or intravenous urogram, Consecutive patients were randomized to either a single sublingual dose of 0.125 mg of hyoscyamine sulfate or a single intravenous dose of 30 mg of ketorolac tromethamine given ov er 1 minute, After 30 minutes, if analgesia was inadequate, patients w ere given rescue medication. Baseline pain scores were obtained using a horizontal, 100-mm visual analog scale. Additional pain scores were obtained at 10 minute intervals for 30 minutes, Upon completion of the study, both patients and physicians completed a global assessment sco re questionnaire. Fifty-four evaluable patients were randomized, Demog raphics and baseline pain scores were similar for each group, Decreasi ng trends in pain over time were observed for both treatment groups, w ith significantly greater pain reduction observed with ketorolac trome thamine as compared to hyoscyamine sulfate, Global evaluations of pain relief revealed better results in the ketorolac tromethamine group th an in the hyoscyamine sulfate group, although this result was not stat istically significant, (Am J Emerg Med 1998;16:557 559. Copyright (C) 1998 by W,B. Saunders Company).