Comparison of the Analgesic Efficacy of Dexketoprofen Trometamol and Meperidine HCl in the Relief of Renal Colic

Abstract

In this study, the analgesic effects of dexketoprofen trometamol and meperidine hydrochloride were compared in patients diagnosed with renal colic. This study was a prospective, randomized, double-blind study. Fifty-two patients, between the ages of 18 and 70 years who were diagnosed with renal colic, were enrolled in the study after obtaining ethics committee approval. Before drug injection, dexketoprofen trometamol and meperidine hydrochloride were placed in closed envelopes, and the patients were randomly given a single dose of intravenous infusion for 20 minutes. Severity of pain and symptoms was evaluated with the numerical rating scale and renal colic symptom score for each patient immediately before administration of drugs and 30 minutes after the end of the application. At the same time, systolic arterial blood pressure, diastolic arterial pressure, respiratory rate, heart rate, nausea, vomiting, and reactions due to drug administration were recorded before and after drug administration. In statistical methods, t test, analysis of variance, and repeated measure analysis were used for the analysis of normally distributed continuous variables and the Mann-Whitney U, Kruskal-Wallis and Friedman tests were used for analysis of not-normally distributed continuous variables. In the analysis of discrete variables, the χ test was used. In both groups, a significant decrease was found in numerical rating scale values measured 30 minutes after drug administration, but the decline in dexketoprofen trometamol group (P = 0.02) was found to be more. Although a significant decrease was found in the renal colic symptom score (P < 0.001) values measured after drug administration in the dexketoprofen trometamol group, no significant decrease was found in the meperidine HCl (P = 0.058) group. After drug administration, a statistically significant decrease was found in the systolic arterial blood pressure, heart rate, and respiratory rate in both groups. Also, a statistically significant decrease was found in the diastolic arterial pressure in the meperidine group. But these changes in vital findings were not serious enough to disrupt patients' clinical status. With this study, we concluded that dexketoprofen trometamol, from the nonsteroidal anti-inflammatory drug group, can be within the primary treatment options for renal colic because of better analgesic efficacy, being well tolerated by patients compared with meperidine hydrochloride.

Increasing Nonsteroidal Anti-inflammatory Drugs and Reducing Opioids or Paracetamol in the Management of Acute Renal Colic: Based on Three-Stage Study Design of Network Meta-Analysis of Randomized Controlled Trials

“…More specifically, the efficacy and safety among NSAIDs, opioids, paracetamol, combination therapy, and placebo were compared according to the classification and pharmacological mechanism of these five interventions in the first stage. Our analysis confirmed that NSAIDs are superior to opioids and paracetamol, which is consistent with some previous studies (Cordell et al, 1996; Wood et al, 2000; Ay et al, 2014; Kaynar et al, 2015; Pathan et al, 2016). The European Association of Urology (EAU) guideline for urolithiasis in 2018 (EAU Guidelines Office) also recommended NSAIDs for very effective treatment of acute renal colic and found they were superior to opioids.…”

Erector spinae plane block vs. Nonsteroidal anti-inflammatory drugs for severe renal colic pain: a pilot clinical feasibility study

“…There are also differences that have been reported in terms of need for additional analgesic and adverse effects based on administration methods. Compared to opioids, NSAIDs have been demonstrated to have less need for additional analgesic when administered intravenously and less rates of vomiting when administered only intramuscularly [22][23][24] . On the other hand, despite the existing complications described for ESP block in the literature, there were not any complications or adverse effects during the course of the present study.…”

Anaphylaxis after intravenous infusion of dexketoprofen trometamol

“…To our knowledge, the case presented here is the first instance in the literature of AS after the use of DT intravenously. Parenteral DT is widely used in acute pain management in the EDs 2, 3, 4. Parenterally or orally administered DT has a good tolerability profile and high analgesic potency 1, 8, 9.…”

“…Oral DT was approved in the European countries through a Mutual Recognition Procedure in 1998 and parenteral formulation in 2002 1 . Parenteral DT is widely used in acute pain management in the emergency department (ED) settings 2, 3, 4. Although diarrhea, indigestion, nausea, stomach pain, and vomiting are described as common adverse drug reactions in the product information of DT, anaphylactic shock (AS) secondary to use of DT is very rare with an incidence of <0.01% 5 .…”