Comparison of the analgesic efficacy of dexketoprofen trometamol, meperidine, and paracetamol in patients presenting with renal colic

This study aimed to compare the analgesic effectiveness of intravenous (IV) dexketoprofen trometamol, IV meperidine and IV paracetamol in patients with renal colic at the Emergency Department of Erciyes University Medical School. Ninety patients, aged 18–65, were enrolled in a double-blind, randomized trial and divided into three groups of 30. Each group received either 50 mg IV dexketoprofen trometamol, 50 mg IV meperidine or 1000 mg IV paracetamol, administered in 250 mL saline over 15 minutes. Pain intensity was assessed at 15, 30 and 60 minutes using a 100-mm visual analog scale (VAS) and a 4-point verbal rating scale (VRS). A successful treatment outcome was defined as a ≥50% reduction in VAS at 30 minutes and patients with a VAS score ≥40 mm at 30 minutes were given fentanyl as rescue analgesia. Results showed significant reductions in VAS scores (±Standard deviation (SD): 53.9± 17.6 mm in the dexketoprofen trometamol group, 62.8 ± 14.6 mm in the meperidine group, and 41.7 ± 19.8 mm in the paracetamol group (Probability value, p < 0.001). The percentage reduction in VAS scores (±SD), was 67.3 ± 20.2% for dexketoprofen trometamol, 71.7 ± 14.2% for meperidine and 51.3 ± 21.0% for paracetamol (p < 0.001). Both dexketoprofen trometamol and meperidine were more effective than paracetamol, but there was no significant difference between them. Rescue analgesia was required in 4 (13.3%) of dexketoprofen trometamol patients, 2 (6.7%) of meperidine patients, and 11 (36.7%) of paracetamol patients. Adverse effects were more common in the meperidine group (33.3%) compared to paracetamol (3.3%) and dexketoprofen trometamol (none)(p < 0.05). In conclusion, IV dexketoprofen trometamol and IV meperidine are equally effective for renal colic and superior to IV paracetamol.

Analgesic efficacy; Dexketoprofen trometamol; Emergency department; Meperidine; Paracetamol; Renal colic

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