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KMID : 0363120190320020097
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Korean Journal of Pain
2019 Volume.32 No. 2 p.97 ~ p.104
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Low-dose intravenous ketamine versus intravenous ketorolac in pain control in patients with acute renal colic in an emergency setting: a double-blind randomized clinical trial
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Sotoodehnia Mehran
Farmahini-Farahani Mozhgan
Safaie Arash
Rasooli Fatemeh
Baratloo Alireza
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Abstract
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Background: This study was conducted to compare the effectiveness of low-dose ketamine versus ketorolac in pain control in patients with acute renal colic presenting to the emergency department (ED).
Methods: This is a double-blind randomized clinical trial. The initial pain severity was assessed using the numerical rating scale (NRS). Then, ketamine or ketorolac was administered intravenously at a dose of 0.6 mg/kg and 30 mg respectively. The pain severity and adverse drug reactions were recorded 5, 15, 30, 60, and 120 min thereafter.
Results: The data of 62 subjects in the ketamine group and 64 patients in the ketorolac group were analyzed. The mean age of the patients was 34.2 ± 9.9 and 37.9 ± 10.6 years in the ketamine and ketorolac group, respectively. There was no significant difference in the mean NRS scores at each time point, except for the 5 min, between the two groups. Despite a marked decrease in pain severity in the ketamine group from drug administration at the 5 min, a slight increase in pain was observed from the 5 min to the 15 min. The rate of adverse drug reactions, including dizziness (P = 0.001), agitation (P = 0.002), increased systolic blood pressure (＞ 140 mmHg), and diastolic blood pressure (＞ 90 mmHg) was higher in the ketamine group.
Conclusions: Low dose ketamine is as effective as ketorolac in pain management in patients with renal colic presenting to the ED. However, it is associated with a higher rate of adverse drug reactions.
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KEYWORD
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Acute pain, Blood pressure, Double-blind method, Drug-related adverse reactions, Hospital emergency service, Ketamine, Ketorolac, Pain management, Randomized controlled trial, Renal colic, Urinary calculi
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