Oral indomethacin for acute renal colic

Wolfson, Allan B.; Yealy, Donald M.

doi:10.1016/0735-6757(91)90005-5

Cited by 14 publications

(6 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…acute renal colic. These drugs have been shown in animal models to reverse both the early vasodilatation Previous reports suggest that 17-29% of patients with acute obstruction have abnormalities on DU, despite and later vasoconstriction that occur with acute renal obstruction [18,19]. Thus, their use may aCect the normal grey-scale US [6,7]; such abnormalities were detected in 35% of the present patients.…”

Section: Ba Bbmentioning

confidence: 62%

“…Cronan and Tublin [ 12] discussed the effect of NSAIDs in the management of patients with acute renal colic. These drugs have been shown in animal models to reverse both the early vasodilatation and later vasoconstriction that occur with acute renal obstruction [ 18, 19]. Thus, their use may affect the expected changes in renal RI; in previous studies, many patients had received NSAIDs before imaging.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Resistive index in renal colic: a prospective study

Shokeir

Abdulmaaboud

1999

BJU International

View full text Add to dashboard Cite

Objective To study the role of Doppler ultrasonography −0.001 (0.02), respectively (P<0.001). For all the patients, RI was sensitive in 77% and specific in 83%, (DU) in the diagnosis of acute unilateral renal obstruction.and DRI was sensitive in 88% and specific in 98%. Obstructed kidneys showing delayed pelvicalyceal fillPatients and methods In all, 117 patients with suspected renal colic were evaluated by intravenous urography ing with excretion of contrast medium (n=42) had significantly higher values of RI and DRI than (IVU) and DU, with determination of the resistive index (RI) and the diCerence between the RI of ipsilatobstructed kidneys without delayed filling (n=26). The RI and DRI were more sensitive in the former eral and contralateral kidneys (DRI). RI and DRI were considered positive with values of Á0.70 and Á0.06, group. Among patients with obstruction, the RI did not relate to the time of delay of filling with contrast respectively. IVU results were considered the 'gold standard' with which renal DU findings were medium, the duration of renal colic or the level of ureteric obstruction. compared. Results IVU showed both kidneys to be normal in 49Conclusions Renal DU is a sensitive and highly specific test that can contribute significantly to the diagnosis patients and unilateral ureteric obstruction with a normal contralateral kidney in 68. The mean (sd) RI of acute unilateral renal obstruction. It can replace the IVU, particularly in situations where IVU is was 0.73 (0.05) in 68 obstructed kidneys, significantly higher than the mean RI of 0.64 (0.05) in 166 normal undesirable. Keywords Renal obstruction, Doppler ultrasonography, kidneys (P<0.001). The DRI in patients with unilateral obstruction was significantly higher than that in diagnosis, resistive index patients with both kidneys normal, at 0.09 (0.05) and patients were prospectively evaluated using renal ultra-

show abstract

Section: Ba Bbmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Resistive index in renal colic: a prospective study

Shokeir

Abdulmaaboud

1999

BJU International

View full text Add to dashboard Cite

show abstract

“…Several studies have demonstrated that nonsteroidal antiinflammatory drugs (NSAIDs) are effective in the treatment of renal colic. [3][4][5][6][7][8][9][10][11] Ketorolac is effective for the treatment of renal colic, 10,11 does not require close patient monitoring and is not associated with untoward sedation.…”

Section: Introductionmentioning

confidence: 99%

The NARC (Nonsteroidal Anti-inflammatory in Renal Colic) Trial. Single-dose intravenous ketorolac versus titrated intravenous meperidine in acute renal colic: a randomized clinical trial

Wood

Christenson

Innes

et al. 2000

CJEM

View full text Add to dashboard Cite

Objectives:Intravenous (IV) opioid titration is an accepted method of relieving acute renal colic. Studies have shown that nonsteroidal anti-inflammatory drugs (NSAIDs) are also effective in this setting. Our objective was to compare single-dose ketorolac and titrated meperidine, both administered intravenously, with respect to speed and degree of analgesia, adverse effects and functional status. Our primary hypothesis was that these agents provide equivalent analgesia within 60 minutes. Our secondary hypotheses were that ketorolac-treated patients would experience fewer adverse effects and would be better able to resume usual activity.Methods:This was a multicentre, double-blind randomized equivalence trial in a convenience sample of patients age 18–65 with moderate or severe renal colic, documented by intravenous pyelogram, ultrasound or stone passage. Meperidine-treated patients received 50 mg IV meperidine at 0 minutes, then 25–50 mg every 15 minutes as needed for ongoing pain. Ketorolac-treated patients received 30 mg IV ketorolac at 0 minutes and placebo injections every 15 minutes as needed. Pain levels and adverse effects were assessed every 15 minutes, and functional status was evaluated at 60 minutes. Our primary outcome was the proportion of patients with mild or no pain at 60 minutes.Results:Overall, 49 of 77 meperidine-treated patients (64%; 95% confidence interval [CI], 53%–75%) and 47 of 65 ketorolac-treated patients (72%; 95% CI, 61%–83%) achieved successful pain relief at 60 minutes (pvalue for equivalence = 0.002). Ten percent of meperidine-treated patients and 44% of ketorolac-treated patients were able to resume usual activity at 60 minutes (p= 0.001).Conclusions:In the doses studied, single-dose IV ketorolac is as effective as titrated IV meperidine for the relief of acute renal colic and causes less functional impairment.

show abstract

“…Cronan and Tublin [ 8] addressed the effect of NSAIDs in the management of patients with acute renal colic. These drugs have been shown in animal models to reverse both the early vasodilatation and later vasoconstriction that occur with acute renal obstruction [ 10, 11]. Thus, their use may alter the expected changes in renal RI.…”

Section: Discussionmentioning

confidence: 99%

“…From recent clinical research we showed that DU is an accurate method for the diagnosis of acute renal obstruction and can replace IVU, particularly in situations in which IVU is contraindicated [ 9]. Although NSAIDs are frequently used to relieve acute renal colic, they have been shown in animal models to affect the haemodynamic changes that occur with acute renal obstruction [ 10, 11]. It is not known whether NSAIDs affect DU values in patients with acute renal colic.…”

Section: Introductionmentioning

confidence: 99%

Resistive index in renal colic: the effect of nonsteroidal anti‐inflammatory drugs

et al. 1999

View full text Add to dashboard Cite

Objective To investigate the eCect of nonsteroidal antiSix hours after giving diclofenac, the mean RI of normal kidneys remained stable and that of the inflammatory drugs (NSAIDs) on the findings of Doppler ultrasonography (DU) in patients with acute obstructed kidneys decreased significantly to 0.67 (0.06) (P<0.001) and was almost stable at 12 h. unilateral renal obstruction. Patients and methods The study included 60 patients Nevertheless, the mean RI of the obstructed kidneys remained significantly higher than that of the normal (120 kidneys) with unilateral loin pain suspected to be of renal origin. All patients were evaluated using kidneys at 6 and 12 h after diclofenac. The mean DRI decreased significantly from 0.11 (0.04) at baseline to renal ultrasonography (US) and intravenous urography (IVU) during the attack of loin pain and before 0.06 (0.04) at 6 h after diclofenac (P<0.001) and remained almost stable at 12 h. In the 10 patients giving any medication. Then the patients were given 75 mg diclofenac sodium and DU studies were repeated undergoing DU after the relief of obstruction, the mean RI returned to normal. At baseline, RI was sensitive at 6 and 12 h. In 10 patients with acute renal colic, DU was possible 12-24 h after the relief of ureteric in 70% and specific in 98%, while DRI was sensitive in 88% and specific in all cases. Six hours after obstruction. The mean resistive index (RI) and DRI at baseline were compared with the mean values 6 and diclofenac, the specificity of RI and DRI remained stable while the sensitivity decreased significantly to 12 h after giving diclofenac. The RI and DRI were considered positive at values Á0.70 and Á0.06, 50% and 68%, respectively. Conclusion NSAIDs significantly decrease the RI of acutrespectively. The sensitivity, specificity and overall accuracy of RI and DRI values before and after giving ely obstructed kidneys, causing a significant reduction in the sensitivity of DU values identifying acute renal diclofenac were calculated using IVU as the reference standard.obstruction. To evaluate acute loin pain, DU should be carried out while the patient is in pain and before Results IVU showed that both kidneys were normal in 20 patients that 40 had unilateral obstruction. At giving NSAIDs. Keywords Renal resistive index, renal colic, diagnosis, baseline, the mean (sd) RI was 0.72 (0.06) in the 40 obstructed kidneys, significantly higher than the RI of obstruction 0.60 (0.06) for the 60 normal kidneys (P<0.001).obstruction [10,11]. It is not known whether NSAIDs

show abstract

Oral indomethacin for acute renal colic

Cited by 14 publications

References 12 publications

Resistive index in renal colic: a prospective study

Resistive index in renal colic: a prospective study

The NARC (Nonsteroidal Anti-inflammatory in Renal Colic) Trial. Single-dose intravenous ketorolac versus titrated intravenous meperidine in acute renal colic: a randomized clinical trial

Resistive index in renal colic: the effect of nonsteroidal anti‐inflammatory drugs

Contact Info

Product

Resources

About