The Effects of Intravenously Administered Tramadol, Dexketoprofen Trometamol, and Midazolam in the Management of Renal Colic Pain; A Prospective Randomized Study

Abstract

Objective: This study aims to assess the effects of analgesic treatment combinations on ultrasonography findings and pain scales in patients with renal colic pain who were admitted to the emergency department of Gaziantep University Medical Faculty.
Methods: This prospective randomized clinical study was conducted in 100 patients with renal colic pain who were admitted to the emergency department of Gaziantep University Medical Faculty between September 2013 and September 2014. The patients were divided into four groups: the first group received tramadol, the second received dexketoprofen trometamol, the third received a tramadol-midazolam combination, and the fourth group received a dexketoprofen trometamol-midazolam combination. Blood pressure, pulse, and bedside renal ultrasonography (USG) findings were evaluated. Pain severity levels were assessed using the visual analog scale (VAS) and the renal colic symptom score (RCSS), and were recorded as pre-treatment (0 min) and post-treatment (30 min) scores. These values were then statistically compared.
Results: There was no statistically significant difference among the four groups in terms of gender and age (p=0.951 and p=0.890, respectively). A significant decrease was detected in the pre-treatment (0 min) and post-treatment (30 min) VAS and RCSS scores of all groups. The largest decrease was observed in the tramadol-midazolam group in the between-group comparison. In the evaluation of the alterations of the bedside USG findings, the largest change in renal parenchymal diameter of painful kidney was also observed in the tramadol-midazolam group.
Conclusion: The efficacy and safety of a tramadol-midazolam combination as an analgesic in management of renal colic may be used as an alternative, or add-on, therapy to currently available options.