Department of Emergency Medicine, Başakşehir Çam Ve Sakura City Hospital, Istanbul, Turkey.
Department of Emergency Medicine, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey.
Urolithiasis. 2023 Oct 12;51(1):121. doi: 10.1007/s00240-023-01496-6.
It is important to do a fast and effective treatment for patients with renal colic pain in emergency departments for both patients' comfort and clinicians' patient management. In this study, we aimed primarily to test the efficacy of intradermal sterile water application as a rapid and effective treatment in severe renal colic. This is a single-centre, prospective, randomised controlled trial. Study group consists of patients with severe renal colic related to urolithiasis. Patients were randomly divided into three groups. The first group received only intramuscular diclofenac sodium, the second group received intramuscular diclofenac sodium and intradermal sterile water, and the third group received intramuscular diclofenac sodium together with intravenous fentanyl. Numerical Rating Scale was used to determine the level of pain before and after the treatment at the 1st, 5th, 15th, 30th, 60th and 120th minutes. 95 out of 201 patients with severe renal colic pain randomly divided into 3 groups. The pre-treatment pain severity of the groups was similar (p = 0.228). We found that the decrease in pain intensity was significantly faster in the intradermal sterile water group than the other groups even in the first minute. Percentages of patients who had 50% pain reduction, which is considered as successful treatment, was higher in the intradermal sterile water group (which had 75.9% success rate) in the first 5 min compared to the IM diclofenac sodium group (which had 7.1% success rate) and IV fentanyl group (which had 25% success rate) (p < 0.001). According to the results, pain control was achieved much faster than the other methods with intradermal sterile water injection. All methods were found to be effective in relieving the pain of the patients.
在急诊科，为了患者的舒适和临床医生的患者管理，对肾绞痛患者进行快速有效的治疗非常重要。在这项研究中，我们主要旨在测试皮内无菌水应用作为一种快速有效的治疗严重肾绞痛的疗效。这是一项单中心、前瞻性、随机对照试验。研究组包括与尿路结石相关的严重肾绞痛患者。患者随机分为三组。第一组仅接受肌肉注射双氯芬酸钠，第二组接受肌肉注射双氯芬酸钠和皮内无菌水，第三组接受肌肉注射双氯芬酸钠和静脉注射芬太尼。使用数字评分量表在治疗前和治疗后第 1、5、15、30、60 和 120 分钟时确定疼痛程度。201 例严重肾绞痛患者随机分为 3 组，其中 95 例。三组患者治疗前疼痛严重程度相似（p=0.228）。我们发现，皮内无菌水组的疼痛强度下降速度明显快于其他组，甚至在第 1 分钟。在第 5 分钟内，皮内无菌水组有 50%疼痛缓解的患者比例（认为是成功治疗）明显高于肌肉注射双氯芬酸钠组（成功率为 7.1%）和静脉注射芬太尼组（成功率为 25%）（p<0.001）。结果表明，与其他方法相比，皮内无菌水注射可更快地控制疼痛。所有方法都被发现能有效缓解患者的疼痛。
