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Acetaminophen Can Be Used Effectively Instead Of Morphine To Treat Renal Colic

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What's This?

Acetaminophen Can Be Used Effectively Instead Of Morphine To Treat Renal Colic

Background Information:
Pain due to kidney stones can be treated with morphine, which can have side-effects like hypotension, respiratory depression and apnea, nausea, and vomiting.

The study was conducted to compare the effect of intravenous acetaminophen with that of intravenous morphine in terms of lesser or no side-effects.

Aim of the study
The aim of the study is determine the efficacy of acetaminophen to reduce hypotension, decrease dizziness, and reduce pain in patients with renal colic.

Study criteria
Patients in the age group of 15-80 years with renal colic being referred to the emergency ward were included in the study. The patients weighing between 60-80kg were only included.

Subjects who were addicted and allergic to opioids and acetaminophen, those who had received analgesics within the 6 hours of the study start were excluded from the study. Also patients with kidney transplantation, heart failure, renal failure, respiratory failure, liver failure, blindness, people who cannot speak were excluded from the study.

Study design
The study is a randomized controlled trial with 124 patients with renal colic; 62 patients in each group. After performing the urine analysis and ultrasonography, patients were selected based on the inclusion criteria. The pain was analyzed using visual analogue scale (VAS) ruler. Morphine (0.1mg/kg) and acetaminophen (15mg/kg) was administered to the groups based on randomization. Morphine was administered slowly over a 15min period to prevent the release of histamine. Acetaminophen was also administered at a slow rate. The pain was assessed just before the drug administration and 30 min after the administration. Data was analyzed using SPSS, Chi-square, ANOVA and logistic regression.

Measurement

  • Results were analyzed by SPSS.18, Chi square, Anova, and regression.

Results

  • No significant difference was found between the two groups in pain relief based on age and weight.
  • There was no significant difference between the two groups in the mean of pain scores before the intervention.
  • After the intervention, the morphine and the acetaminophen were effective to reduce the pain separately.
  • When the mean differences of the two groups in the pain score was compared using the independent t-test, there was a significant difference between the drug actions. Morphine was found to be more effective in pain relief than acetaminophen.

Effect of drugs based on age

 

Effect of drugs on males and females

 

Effect of drugs on weight

There was no significant difference in the mean pain score of the drugs separately.

Complications of the two drugs:

AcetoConclusion

From the study, it can be concluded that morphine is effective at treating renal colic and is associated with a number of side-effects. Acetaminophen when given intravenously can reduce the renal colic, not as effective as morphine but, the side-effects associated with acetaminophen are relatively less.

Reference

Reza Azizkhani et al Comparing the analgesic effect of intravenous acetaminophen and morphine on patients with renal colic pain referring to the emergency department: A randomized controlled trial. J Res Med Sci. 2013 Sep; 18(9): 772–776.
Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3872585/

 

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