Comparing the effects of different amounts of fluid treatments in addition to analgesia in patients admitted to the emergency department with renal colic: A randomized study

Year 2022, Volume: 35 Issue: 1, 17 - 22, 31.01.2022

Lebibe Celebı Cigdem Ozpolat Ozge Onur Haldun Akoglu Erkman Sanrı Arzu Denızbası

https://doi.org/10.5472/marumj.1061180

Abstract

Objective: There are a limited number of studies examining the effect of fluid administration for acute pain relief in patients with
renal colic. We aim to evaluate whether intravenous fluid of different amounts will make a difference regarding pain, in patients who
presented to the emergency department (ED) with flank pain.
Patients and Methods: This single-center, prospective, randomized clinical trial was performed at the ED of a university hospital.
Subjects were randomly assigned to three groups. All received an intramuscular (IM) injection of 75 mg diclofenac sodium and 3 mg
intravenous (IV) morphine. While group 1 did not receive extra treatment, group 2 received 100 cc /hr physiological serum (PS), and
group 3 received 500 cc /hr PS. Pain was assessed by using the visual analogue scale (VAS) ruler for 6 hours.
Results: A total of 201 patients were included. Mean age was 36.16 ± 9.85. At 60 min mean VAS scores were 3.55 ± 1.24 in the first
group, 4.42 ± 1.87 in the second group and 5.02 ± 1.92 in the third group. In the group fluid not given, pain decrease was faster than
others. At 240 min mean VAS scores were similar in all groups.
Conclusion: This study indicates that IV fluids given to patients with renal colic pain was not effective in pain relief.

Keywords

Renal colic, Analgesia, Intravenous fluid, Urolithiasis, VAS

References

• [1] Dellabella M, Milanese G, Muzzonigro G. Randomized trial of the efficacy of tamsulosin, nifedipine and phloroglucinol in medical expulsive therapy for distal ureteral calculi. J Urol 2005;174:167-72. doi: 10.1097/01.ju.000.016.1600.54732.86
• [2] Trinchieri A, Coppi F, Montanari E, Del Nero A, Zanetti G, Pisani E. Increase in the prevalence of symptomatic upper urinary tract stones during the last ten years. Eur Urol 2000;37:23-5. doi: 10.1159/000020094
• [3] Hesse A, Brandle E, Wilbert D, Kohrmann KU, Alken P. Study on the prevalence and incidence of urolithiasis in Germany comparing the years 1979 vs. 2000. Eur Urol 2003;44:709-13. doi: 10.1016/s0302-2838(03)00415-9
• [4] Edna TH, Hesselberg F. Acute ureteral colic and fluid intake. Scand J Urol Nephrol 1983;17:175-8. doi: 10.3109/003.655.98309180164
• [5] Kirschner J, Wilbur L. Do fluids facilitate stone passage in acute ureteral colic? Ann Emerg Med 2013;62:36-7. doi: 10.1016/j.annemergmed.2012.08.004
• [6] Urbaniak G C, Plous S. Research randomizer [Computer software]. Available at: http://www.randomizer.org/ Accessed on:04.01.2020
• [7] Daudon M, Dore JC, Jungers P, Lacour B. Changes in stone composition according to age and gender of patients: a multivariate epidemiological approach. Urol Res 2004;32:241- 7. doi: 10.1007/s00240.004.0421-y.
• [8] Schade GR, Faerber GJ. Urinary tract stones. Prim Care 2010;37:565-81. doi: 10.1016/j.pop.2010.05.003.
• [9] Scales CD Jr, Curtis LH, Norris RD, et al. Changing gender prevalence of stone disease. J Urol 2007;177:979-82. doi: 10.1016/j.juro.2006.10.069.
• [10] Romero V, Akpinar H, Assimos DG. Kidney stones: a global picture of prevalence, incidence, and associated risk factors. Rev Urol 2010;12:e86-96.
• [11] Seitz C, Fajkovic H. Epidemiological gender-specific aspects in urolithiasis. World J Urol 2013;31:1087-92. doi: 10.1007/ s00345.013.1140-1.
• [12] Fink HA, Akornor JW, Garimella PS, et al. Diet, fluid, or supplements for secondary prevention of nephrolithiasis: a systematic review and meta-analysis of randomized trials. Eur Urol 2009;56:72-80. doi: 10.1016/j.eururo.2009.03.031.
• [13] Goldfarb DS, Fischer ME, Keich Y, Goldberg J. A twin study of genetic and dietary influences on nephrolithiasis: a report from the Vietnam Era Twin (VET) Registry. Kidney Int 2005;67:1053-61. doi: 10.1111/j.1523-1755.2005.00170.x.
• [14] Springhart WP, Marguet CG, Sur RL, et al. Forced versus minimal intravenous hydration in the management of acute renal colic: a randomized trial. J Endourol 2006;20:713-6. doi: 10.1089/end.2006.20.713.
• [15] Eisner BH, Reese A, Sheth S, Stoller ML. Ureteral stone location at emergency room presentation with colic. J Urol 2009;182:165-8. doi: 10.1016/j.juro.2009.02.131.
• [16] Özbir S, Can O, Atalay HA, Canat HL, Çakır SS, Ötünçtemur A. Formula for predicting the impaction of ureteral stones. Urolithiasis 2020;48:353-60. doi: 10.1007/s00240.019.01152-y
• [17] Kim SG, Jo IJ, Kim T, et al. Usefulness of protocolized pointof- care ultrasonography for patients with acute renal colic who visited emergency department: A randomized controlled study. Medicina (Kaunas) 2019; 55:717. doi: 10.3390/ medicina55110717.
• [18] Wein AJM, Louis R. Kavoussi MD. Campbell-Walsh Urology. 11th Edition. Philadelphia: Elsevier, 2016:978-1003.
• [19] Takaddus AT, Gautam P, Chandy AJ. A fluid-structure interaction (FSI)-based numerical investigation of peristalsis in an obstructed human ureter. Int J Numer Method Biomed Eng 2018;34:e3104. doi: 10.1002/cnm.3104