Intradermal sterile water injection versus diclofenac sodium in acute renal colic pain: A randomized controlled trial

Am J Emerg Med. 2021 Jun:44:395-400. doi: 10.1016/j.ajem.2020.04.079. Epub 2020 Apr 29.

Abstract

Objectives: We aimed to evaluate the efficacy of intracutaneous sterile water injection (ISWI) to relieve the pain of acute renal colic compared with diclofenac and placebo.

Methods: The study included 150 patients presented to the Emergency Department with renal colic randomized into 3 groups: control group received intracutaneous injections of 0.5 cm3 isotonic saline in the flank, group A received intracutaneous injections of 0.5 cm3 ISWI in the flank, and group B received an intramuscular injection of 75 mg Diclofenac in the gluteal region. The severity of the pain was assessed by a visual analogue scale system at baseline and 30, 45 min, and 60 min after injections. Subjects with inadequate pain relief at 1 h received rescue analgesia.

Results: The mean baseline pain score was 9.6 ± 0.61 in the ISWI group, 9.72 ± 0.64 in the diclofenac group and 9.26 ± 0.89 in the control group. The mean pain score at 30 min of the control group was reduced to 6.9 ± 1.56. This mean at 30 min after ISWI and diclofenac injections were reduced to 1.98 ± 1.41 and 1.88 ± 1.19 respectively. The mean of pain sore of the ISWI and diclofenac group at 45 and 60 min was constant. Rescue analgesics at 1 h were required by 47 patients receiving the saline injection and by 4 patients and by 7 patients receiving ISWI and diclofenac injection respectively.

Conclusions: ISWI and diclofenac were equally effective for the pain relief of acute renal colic.

Keywords: Diclofenac; Renal colic; Sterile water injection.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Acute Disease
  • Adult
  • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage*
  • Contrast Media
  • Diclofenac / administration & dosage*
  • Double-Blind Method
  • Emergency Service, Hospital
  • Female
  • Humans
  • Injections, Intradermal
  • Injections, Intramuscular
  • Male
  • Middle Aged
  • Pain Management / methods*
  • Pain Measurement
  • Renal Colic / diagnostic imaging
  • Renal Colic / drug therapy*
  • Tomography, X-Ray Computed
  • Water / administration & dosage*

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Contrast Media
  • Water
  • Diclofenac