SBMU Journals
  • New Submission
  • Register
  • Login
  • English
    • 简体中文

Archives of Academic Emergency Medicine

  • Home
  • About
    • Policies
    • Editorial Team
    • Reviewer guideline
    • Contact
  • Issues
    • Current
    • Archives
  • Announcements
  • Indexing/Abstracting
  • For authors
    • New Submission
    • Author guidelines
    • Article withdrawal
    • Peer review process
    • FAQ
  • Ethics
    • Ethical requirements
    • Plagiarism Policy
    • Authorship conflicts
    • Malpractice statements
    • Copyright Notice
    • Intellectual properties
    • Preprint Policy
    • Privacy Statement
    • Artificial intelligence & Authorship
    • Retraction Cosiderations
Advanced Search
  1. Home
  2. Archives
  3. Vol. 4 No. 4 (2016): Autumn (November)
  4. Original/Research Article

Vol. 4 No. 4 (2016)

November 2016

Intravenous Morphine vs Intravenous Ketofol for Treating Renal Colic; a Randomized Controlled Trial

  • Gholamreza Faridaalaee
  • Neda Mohammadi
  • Seyedeh Zahra Merghati
  • Fatemeh Keyghobadi Khajeh
  • Bahman Naghipour
  • Mahboob Pouraghaei
  • Sajjad Ahmadi

Archives of Academic Emergency Medicine, Vol. 4 No. 4 (2016), 1 November 2016 , Page 202-206
https://doi.org/10.22037/aaem.v4i4.251 Published: 2018-12-16

  • View Article
  • Download
  • Cite
  • References
  • Statastics
  • Share

Abstract

Introduction: The main purpose of emergency department (ED) management for renal colic  is prompt pain relief. The present study aimed to compare the analgesic effects of intravenus (IV) ketofol with morphine in management of ketorolac persistent renal colic. Methods: This study is a single blind randomized, clinical trial, on patients who were presented to ED with renal colic, whose pain was resistant to 30 mg IV ketorolac. The patients were randomly assigned to either IV morphine (0.1 mg/kg) or IV ketofol (0.75 mg/kg propofol and 0.75 mg/kg) and the measures of treatment efficacy were compared between the groups after 5 and 10 minutes. Results: 90 patients with mean age of 38.01 ± 9.78 years were randomly divided into 2 groups of 45 (66.7% male). Treatment failure rate was significantly lower in ketofol group after 5 (20% vs 62.2%, p < 0.001) and 10 minutes (11.1% vs 44.4%, p < 0.001). ARR and NNT for ketofol after 5 miutes were 42.22% (95% CI: 23.86 – 60.59) and 3 (95% CI: 1.7 - 4.2), respectively. After 10 minutes, these measures reached 33.33 (95% CI:16.16 – 50.51) and 4 (95% CI: 2.0 - 6.2), respectively. NNH and ARI for hallucination or agitation were 12 (95%CI: 5.8 - 174.2) and 8.89% (0.57 - 17.20), respectively. Conclusion: The results of the present study, showed the significant superiority of ketofol (NNT at 5 minute = 3 and NNT at 10 minute = 4)  in ketorolac resistant renal colic pain management. However, its NNH of 12, could limit its routine application in ED for this purpose.
Keywords:
  • Renal colic
  • pain
  • morphine
  • propofol
  • ketamine
  • PDF
  • HTML

How to Cite

1.
Faridaalaee G, Mohammadi N, Merghati SZ, Keyghobadi Khajeh F, Naghipour B, Pouraghaei M, et al. Intravenous Morphine vs Intravenous Ketofol for Treating Renal Colic; a Randomized Controlled Trial. Arch Acad Emerg Med [Internet]. 2018 Dec. 16 [cited 2026 Jul. 27];4(4):202-6. Available from: https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/251
  • ACM
  • ACS
  • APA
  • ABNT
  • Chicago
  • Harvard
  • IEEE
  • MLA
  • Turabian
  • Vancouver
  • Endnote/Zotero/Mendeley (RIS)
  • BibTeX

References

Refrences

Holdgate A, Pollock T. Systematic review of the relative efficacy of non-steroidal anti-inflammatory drugs and opioids in the treatment of acute renal colic. Bmj. 2004;328(7453):1401.

Green BR. Renal Calculi: Emergency Department Diagnosis And Treatment. Emergency Medicine Practice. 2011:2.

HIATT RA, DALES LG, FRIEDMAN GD, HUNKELER EM. Frequency of urolithiasis in a prepaid medical care program. American journal of epidemiology. 1982;115(2):255-65.

Soucie JM, Thun MJ, Coates RJ, McClellan W, Austin H. Demographic and geographic variability of kidney stones in the United States. Kidney international. 1994;46(3):893-9.

TramÅ•r DM, Williams J, Carroll D, Wiffen P, Moore R, McQuay H. Comparing analgesic efficacy of nonâ€steroidal antiâ€inflammatory drugs given by different routes in acute and chronic pain: a qualitative systematic review. Acta Anaesthesiologica Scandinavica. 1998;42(1):71-9.

Ricardo Buenaventura M, Rajive Adlaka M, Nalini Sehgal M. Opioid complications and side effects. Pain physician. 2008;11:S105-S20.

Safdar B, Degutis LC, Landry K, Vedere SR, Moscovitz HC, D’Onofrio G. Intravenous morphine plus ketorolac is superior to either drug alone for treatment of acute renal colic. Annals of emergency medicine. 2006;48(2):173-81. e1.

Willman EV, Andolfatto G. A prospective evaluation of “ketofolâ€(ketamine/propofol combination) for procedural sedation and analgesia in the emergency department. Annals of emergency medicine. 2007;49(1):23-30.

White PF, Way WL, Trevor AJ. Ketamine--its pharmacology and therapeutic uses. Anesthesiology. 1982(56):119-36.

Green SM, Rothrock SG, Lynch EL, Ho M, Harris T, Hestdalen R, et al. Intramuscular ketamine for pediatric sedation in the emergency department: safety profile in 1,022 cases. Annals of emergency medicine. 1998;31(6):688-97.

Katalinic N, Lai R, Somogyi A, Mitchell PB, Glue P, Loo CK. Ketamine as a new treatment for depression: A review of its efficacy and adverse effects. Australian and New Zealand Journal of Psychiatry. 2013;47(8):710-27.

Shafer A, Doze V, Shafer S, White P. Pharmacokinetics and pharmacodynamics of propofol infusions during general anesthesia. Anesthesiology. 1988;69(3):348-56.

Nejati A, Moharari RS, Ashraf H, Labaf A, Golshani K. Ketamine/Propofol Versus Midazolam/Fentanyl for Procedural Sedation and Analgesia in the Emergency Department: A Randomized, Prospective, Doubleâ€Blind Trial. Academic Emergency Medicine. 2011;18(8):800-6.

Bird SB, Dickson EW. Clinically significant changes in pain along the visual analog scale. Annals of emergency medicine. 2001;38(6):639-43.

Gallagher EJ, Liebman M, Bijur PE. Prospective validation of clinically important changes in pain severity measured on a visual analog scale. Annals of emergency medicine. 2001;38(6):633-8.

Todd KH. Clinical versus statistical significance in the assessment of pain relief. Annals of emergency medicine. 1996;27(4):439-41.

Cordell WH, Wright SW, Wolfson AB, Timerding BL, Maneatis TJ, Lewis RH, et al. Comparison of intravenous ketorolac, meperidine, and both (balanced analgesia) for renal colic. Annals of emergency medicine. 1996;28(2):151-8.

Larkin GL, Peacock WF, Pearl SM, Blair GA, D'Amico F. Efficacy of ketorolac tromethamine versus meperidine in the ED treatment of acute renal colic. The American journal of emergency medicine. 1999;17(1):6-10.

Oosterlinck W, Philp N, Charig C, Gillies G, Hetherington J, Lloyd J. A Doubleâ€Blind Single Dose Comparison of Intramuscular Ketorolac Tromethamine and Pethidine in the Treatment of Renal Colic. The Journal of Clinical Pharmacology. 1990;30(4):336-41.

Persson NH, Bergqvist D, Melander A, Zederfelt B. Comparison of a narcotic (oxicone) and a non-narcotic anti-inflammatory analgesic (indoprofen) in the treatment of renal colic. Acta chirurgica Scandinavica. 1985;151(2):105-8.

Sandhu D, Iacovou J, Fletcher M, Kaisary A, Philip N, Arkell D. A comparison of intramuscular ketorolac and pethidine in the alleviation of renal colic. British journal of urology. 1994;74(6):690-3.

Smith LA, Carroll D, Edwards JE, Moore RA, McQuay HJ. Single-dose ketorolac and pethidine in acute postoperative pain: systematic review with meta-analysis. British journal of anaesthesia. 2000;84(1):48-58.

Holdgate A, Oh CM. Is there a role for antimuscarinics in renal colic? A randomized controlled trial. The Journal of urology. 2005;174(2):572-5; discussion 5.

Masoumi K, Forouzan A, Asgari Darian A, Feli M, Barzegari H, Khavanin A. Comparison of clinical efficacy of intravenous acetaminophen with intravenous morphine in acute renal colic: a randomized, double-blind, controlled trial. Emergency medicine international. 2014;2014:571326.

Azizkhani R, Pourafzali SM, Baloochestani E, Masoumi B. Comparing the analgesic effect of intravenous acetaminophen and morphine on patients with renal colic pain referring to the emergency department: A randomized controlled trial. Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences. 2013;18(9):772-6.

Mortelmans LJ, Desruelles D, Baert JA, Hente KR, Tailly GG. Use of tramadol drip in controlling renal colic pain. Journal of endourology. 2006;20(12):1010-5.

Hassanian-Moghaddam H, Farajidana H, Sarjami S, Owliaey H. Tramadol-induced apnea. The American journal of emergency medicine. 2013;31(1):26-31.

Arora S. Combining ketamine and propofol (“ketofolâ€) for emergency department procedural sedation and analgesia: a review. Western Journal of Emergency Medicine. 2008;9(1):20.

  • Abstract Viewed: 415 times
  • PDF Downloaded: 178 times
  • HTML Downloaded: 118 times

Download Statastics

  • Linkedin
  • Twitter
  • Facebook
  • Google Plus
  • Telegram

Make a Submission

Make a Submission

SJR

SCImago Journal & Country Rank

COPE

Current Issue

  • Atom logo
  • RSS2 logo
  • RSS1 logo

Information

  • For Readers
  • For Authors
  • For Librarians
  • Home
  • Archives
  • Submissions
  • About the Journal
  • Editorial Team
  • Contact

This journal is distributed under the terms of CC BY-NC 3.0. Design and publishing by SBMU journals. All credits and honors to PKP for their OJS. 

 Sitemap | ISSN-ONLINE: 2645-4904

Support Contact: ma.saghaei63@gmail.com

With the goal of net zero carbon emissions, this journal is published only in electronic format.

Powered by OJSPlus