Emerg (Tehran). 2016 Nov;4(4):202-206.

Intravenous Morphine vs Intravenous Ketofol for Treating Renal Colic; a Randomized Controlled Trial.

Faridaalaee G1, Mohammadi N2, Merghati SZ3, Keyghobadi Khajeh F4, Naghipour B5, Pouraghaei M6, Ahmadi S1.

1Emergency Medicine Department, Maragheh University of Medical Sciences, Maragheh, Iran.

2Emergency Medicine Department, Urmia University of Medical Sciences, Urmia, Iran.

3International branch of Urmia University of Medical Sciences, Urmia, Iran.

4Department of Community Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

5Anesthesiology Department, Tabriz University of Medical Sciences, Tabriz, Iran.

6Department of Emergency Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

Abstract

INTRODUCTION:

The main purpose of emergency department (ED) management for renal colic is prompt pain relief. The present study aimed to compare the analgesic effects of intravenus (IV) ketofol with morphine in management of ketorolac persistent renal colic.

METHODS:

This study is a single blind randomized, clinical trial, on patients who were presented to ED with renal colic, whose pain was resistant to 30 mg IV ketorolac. The patients were randomly assigned to either IV morphine (0.1 mg/kg) or IV ketofol (0.75 mg/kg propofol and 0.75 mg/kg) and the measures of treatment efficacy were compared between the groups after 5 and 10 minutes.

RESULTS:

90 patients with mean age of 38.01 ± 9.78 years were randomly divided into 2 groups of 45 (66.7% male). Treatment failure rate was significantly lower in ketofol group after 5 (20% vs 62.2%, p < 0.001) and 10 minutes (11.1% vs 44.4%, p < 0.001).

ARR and NNT for ketofol after 5 minutes were 42.22% (95% CI: 23.86 - 60.59) and 3 (95% CI: 1.7 - 4.2), respectively.

After 10 minutes, these measures reached 33.33 (95% CI:16.16 - 50.51) and 4 (95% CI: 2.0 - 6.2), respectively.

NNH and ARI for hallucination or agitation were 12 (95%CI: 5.8 - 174.2) and 8.89% (0.57 - 17.20), respectively.

CONCLUSION:

The results of the present study, showed the significant superiority of ketofol (NNT at 5 minute = 3 and NNT at 10 minute = 4) in ketorolac resistant renal colic pain management. However, its NNH of 12, could limit its routine application in ED for this purpose.

KEYWORDS:

Renal colic; ketamine; morphine; pain; propofol

PMID:

27800541