Diclofenac versus Combination of Dexketoprofen and Hyoscine N-Butyl Bromide in the Treatment of Renal Colic in the Emergency Room Setting: A Single-Blinded Randomized Controlled Trial in a Tertiary Government Hospital in the Philippines

Abstract

Introduction: Renal colic pain is a very severe pain usually being consulted at the emergency room. New pain relievers together with combination of other drugs is used for symptomatic relief. This study compared the efficacy and tolerability of Diclofenac versus Dexketoprofen with Hyoscine Nbutyl bromide (HNBB) in the management of acute renal colic at the emergency room.

Methodology: This was a single blind, randomized prospective study done from June 1, 2017 to August 31, 2017 at the emergency department of the Jose Reyes Memorial Medical Center. Allocation and randomization were done into two treatment groups: the Diclofenac and Dexketoprofen + HNBB. Subjectivity of pain relief was based using visual analogue score (VAS), this was taken before the treatment and 15, 30 and 60 minutes after administration of treatment.

Results: Twenty nine (29) patients were grouped into two: Dicloenac group (n=15) and Dexketoprophen + HNBB group (n= 14). Pain reduction in the combination group had a faster pain relief compared to Diclofenac alone with a 41% and 17% decline, respectively. The study showed that a faster pain relief was achieved with the Dexkoprophen + HNBB combination compared to Diclofenac alone.

Conclusion: Timing and onset of pain control in patients presenting with renal colic pain is essential in the emergency room setting to provide adequate relief. The use of the combination therapy of Dexkotoprofen + HNNB may have a significant advantage in terms of rapid onset of relief.