Intravenous Lidocaine Compared to Fentanyl in Renal Colic Pain Management; a Randomized Clinical Trial
Archives of Academic Emergency Medicine,
Vol. 5 No. 1 (2017),
1 January 2017
,
Page e82
https://doi.org/10.22037/aaem.v5i1.207
Abstract
Introduction: Using alpha blockers such as intravenous (IV) lidocaine has been deemed effective in controlling acute pain. Therefore, the current study was designed with the aim of evaluating the efficiency of IV lidocaine in comparison to IV fentanyl in pain management of patients with renal colic in emergency department (ED). Methods: In this double blind clinical trial, 18-65 year old patients that presented to ED with colicky flank pain and met the inclusion criteria of the study were allocated to either lidocaine or fentanyl group using block randomization and compared regarding pain severity 5, 10, 15, and 30 minutes after drug administration. Results: 90 patients with the mean age of 35.75±8.87 years were divided into 2 groups of 45 (90% male). The 2 groups were not significantly different regarding the studied baseline variables. Pain severity was not significantly different between the 2 groups at various times after injection. Treatment failure rate 15 minutes after injection was 44.4% (20 cases) in IV lidocaine and 17.8% (8 cases) in IV fentanyl group (p = 0.006). These rates were 26.6% (12 patients) versus 22.2% 30 minutes after injection (p = 0.624). Absolute risk increase of treatment failure in case of using lidocaine was 26.7 (95% CI: 8.3-44.9) in the 15th minute and 4.4 (95% CI: 13.3-22.2) 30 minutes after injection. Number needed to harm (NNH) in treatment with lidocaine 15 and 30 minutes after injection were 4 (95% CI: 2.2-12.0) and 23, respectively. Conclusion: Although mean pain severity was not significantly different between IV fentanyl and lidocaine at various times after injection, treatment failure rate was significantly higher in the IV lidocaine group 15 minutes after injection.- Fentanyl
- lidocaine
- renal colic
- pain management
- analgesia
- emergency service
- hospital
How to Cite
References
Edwards J, Sloan E, Eder S, Chan S. Renal colic patient pain management in the emergency department. Annals of Emergency Medicine. 2004;44(4):S58.
Stamatelou KK, Francis ME, Jones CA, Nyberg LM, Curhan GC. Time trends in reported prevalence of kidney stones in the United States: 1976–1994. Kidney international. 2003;63(5):1817-23.
Scales CD, Smith AC, Hanley JM, Saigal CS, Project UDiA. Prevalence of kidney stones in the United States. European urology. 2012;62(1):160-5.
Soleimanpour H, Hassanzadeh K, Vaezi H, Golzari SE, Esfanjani RM, Soleimanpour M. Effectiveness of intravenous lidocaine versus intravenous morphine for patients with renal colic in the emergency department. BMC urology. 2012;12(1):13.
Dellabella M, Milanese G, Muzzonigro G. Randomized trial of the efficacy of tamsulosin, nifedipine and phloroglucinol in medical expulsive therapy for distal ureteral calculi. The Journal of urology. 2005;174(1):167-72.
Iguchi M, Katoh Y, Koike H, Hayashi T, Nakamura M. Randomized trial of trigger point injection for renal colic. International journal of urology. 2002;9(9):475-9.
Barzegari H, Motamed H, Ziapour B, Hajimohammadi M, Kadkhodazadeh M. Intranasal Lidocaine for Primary Headache Management in Emergency Department; a Clinical Trial. Emergency. 2017;5(1):e79.
Ferrini R, Paice J. How to initiate and monitor infusional lidocaine for severe and/or neuropathic pain. The journal of supportive oncology. 2004;2(1):90.
Afhami M, Salmasi P. Studying analgesic effect of preincisional infiltration of lidocaine as a local anesthetic with different concentrations on postoperative pain. Pak J Med Sci. 2009;25(5):821-4.
Forouzan A, Barzegari H, Motamed H, Khavanin A, Shiri H. Intravenous Lidocaine versus Morphine Sulfate in Pain Management for Extremity Fractures; a Clinical Trial. Emergency. 2017;5(1):e68.
Marret E, Rolin M, Beaussier M, Bonnet F. Metaâ€analysis of intravenous lidocaine and postoperative recovery after abdominal surgery. British Journal of Surgery. 2008;95(11):1331-8.
Ockerblad NF, Carlson HE, Simon JF. The Effect of Morphine Upon the Human Ureter. The Journal of Urology. 1935;33(4):356-62.
Marx J, Walls R, Hockberger R. Rosen's Emergency Medicine-Concepts and Clinical Practice E-Book: Elsevier Health Sciences; 2013.
Khaniha RB, Safarinezhad MR, Markazi Moghadam N, Valimanesh HA, Abd Elahian M. The comparison of the efficacy of common pain management in acute renal colic. Annals of Military and Health Sciences Research 2004;2(3):381-6.
Belkouch A, Zidouh S, Rafai M, Chouaib N, Sirbou R, Elbouti A, et al. Does intranasal fentanyl provide efficient analgesia for renal colic in adults? The Pan African medical journal. 2015;20.
Firouzian A, Alipour A, Dezfouli HR, Kiasari AZ, Baradari AG, Zeydi AE, et al. Does lidocaine as an adjuvant to morphine improve pain relief in patients presenting to the ED with acute renal colic? A double-blind, randomized controlled trial. The American journal of emergency medicine. 2016;34(3):443-8.
- Abstract Viewed: 305 times
- PDF Downloaded: 155 times
- HTML Downloaded: 39 times
