The Efficacy of Intranasal Desmopressin as an Adjuvant in the Acute Renal Colic Pain Management

Abstract

The aim of this study was to compare analgesic effect of intramuscular (IM) sodium diclofenac and intranasal desmopressin combination with IM sodium diclofenac alone in patients with acute renal colic. In this randomized double-blind clinical trial, all patients aged 18 to 55 years who were diagnosed as acute renal colic and met the inclusion and exclusion criteria were randomized into two groups to receive 40 μg intranasal desmopressin spray and 75 mg IM sodium diclofenac combination (Group A) or 75 mg IM sodium diclofenac alone (Group B). The pain score of patients was assessed using a visual analogue scale (VAS) at baseline, 15, 30, 45, and 60 minutes after administration. Of all 159 patients who were assessed for eligibility finally, the results of 120 patients were analyzed. There was no significant difference regarding age and gender between two groups. The baseline VAS score was not significantly different between two groups (P = 0.44). The Mean ± SD scores of two groups reduced 15 minutes after drug administration, but this decrease was significantly more in Group A compared with Group B (P = 0.02). This pattern continued in minutes 30, 45, and 60 of drug administration. Our results showed that desmopressin could be used as an effective adjuvant in acute renal colic pain management.

Epidemiological pattern of trauma patients based on the mechanisms of trauma: trends of a regional trauma center in Midwest of Iran

“…Trauma also decreases the disability adjusted life years (DALY) in different communities [5]. Today, trauma is one of the important issues in public health that should be given more attention in the health care system, because not only thousands of deaths and millions of injuries occur due to various trauma annually [6], but also it imposes direct and indirect socio-economic costs on the health care system of communities and individuals [7]. These costs include treatment costs, reduced productivity, stopping activities, and loss of family income at the time of hospitalization [8].…”

Effectiveness of Intravenous Ketorolac versus Intravenous Morphine Sulfate on Pain Control in Patients with Acute Renal Colic: A Phase 3 Randomized Clinical Trial

“…They are responsible for a common and recurrent urological disease [2], and the pain caused by them is known as renal colic [3]. Actually, the acute obstruction of the urinary tract because of the presence of these stones causes dilation, stretching, and spasm [4]. Renal colic usually appears suddenly by pain onset radiating from the flank to the groin [5].…”

“…5 to 12 percent of people at least experience renal colic once in their lifetime [7]. The approximate number of patients that annually refer to hospitals because of the renal colic pain is estimated 1.2 million people which almost accounts for 1% of all hospital admissions [4]. Considering that 90 percent of stones are excreted spontaneously, relieving the patient's pain is in priority in renal colic treatment [8].…”

Desmopressin as an adjuvant to opioids or NSAIDs in treatment of renal colic: a nationwide register-based study

“…Recent studies of safety and efficacy of intranasal desmopressin combined with opioids, NSAIDs or antispasmodics (tramadol, pethidine, diclofenac and hyoscine N‐butyl bromide) found that desmopressin could be used as an effective adjuvant in acute renal colic pain management …”

“…Recent studies of safety and efficacy of intranasal desmopressin combined with opioids, NSAIDs or antispasmodics (tramadol, pethidine, diclofenac and hyoscine N-butyl bromide) found that desmopressin could be used as an effective adjuvant in acute renal colic pain management. [13][14][15] Therefore, although desmopressin is not indicated for use in renal colic, there is an increasing body of literature supporting its analgesic action in these patients. The objective of the current study was to investigate whether, and to what extent, desmopressin is used off-label in clinical practice for pain relief in urolithiasis patients.…”