Comparison of Intranasal Ketamine Versus Iv Morphine in Reducing Pain in Patients With Renal Colic Publisher Pubmed



Farnia MR¹ ; Jalali A² ; Vahidi E³ ; Momeni M³ ; Seyedhosseini J³ ; Saeedi M³ Show Affiliations
Source: American Journal of Emergency Medicine Published:2017

Abstract

Background Various drugs have been used to relieve abdominal pain in patients with renal colic. Ketamine is a popular choice as an analgesic. Objective To compare the effectiveness of intranasal (IN) ketamine versus intravenous (IV) morphine in reducing pain in patients with renal colic. Methods A randomized double-blind controlled trial was performed in 53 patients with renal colic recruited from the emergency department (ED) in 2015. Finally, 40 patients were enrolled in this study. Patients in the ketamine group received IN ketamine 1 mg/kg and IV placebo while patients in the control group received IV morphine 0.1 mg/kg and IN placebo. Our goal was to assess visual analogue scale (VAS) changes between the 2 groups. Patients' VAS scores were reported before and 5, 15, 30 min after drug injection. Results Before drug administration, the mean ± SD VAS score was 7.40 ± 1.18 in the morphine group (group A) and 8.35 ± 1.30 in the ketamine group (group B) (P-value = 0.021). After adjustment by the appropriate analysis, the mean ± SD VAS score in group (A) and (B) at 5 min were (6.07 ± 0.47 vs 6.87 ± 0.47; mean difference − 0.79, 95% confidence interval (CI) − 1.48 to − 1.04) (P-value = 0.025), at 15 and 30 min, the mean ± SD VAS score in group (A) and (B) were (5.24 ± 0.49 vs 5.60 ± 0.49; mean difference − 0.36, 95% CI − 1.08 to 0.34) and (4.02 ± 0.59 vs 4.17 ± 0.59; mean difference − 0.15, 95% CI − 1.02 to 0.71) (P-value = 0.304 and 0.719) respectively. Conclusions IN ketamine may be effective in decreasing pain in renal colic. © 2016 Elsevier Inc.