Butorphanol and meperidine compared in patients with acute ureteral colic.

Pain relief was evaluated in 81 patients with acute ureteral colic and the confirmed presence of a calculus. A randomized double-blind comparison of intramuscular 2 and 4 mg. butorphanol and 80 mg. meperidine was used. Pain intensity and pain relief were evaluated at half hour and hourly intervals for 4 hours. A 2 mg. dose of butorphanol was found to be analgesically equivalent to 80 mg. meperidine, while a 4 mg. dose of butorphanol was found to be more effective than 80 mg. meperidine and 2 mg. butorphanol. Each patient received up to 2 doses of analgesic medication when necessary. There was no significant difference in the incidence of side effects among treatments. One patient had visual hallucinations after a 2 mg. dose of butorphanol, possibly owing to its antagonistic activity to significant narcotic experience given previously at another hospital. There was no other evidence of toxicity with butorphanol. It was found to be a safe, effective and wall tolerated drug for the treatment of ureteral colic and is recommended in place of narcotics.