Intravenous acetaminophen versus morphine sulfate in pain management of acute renal colic: a randomized clinical trial

Objective: The main purpose in the treatment of renal colic patients in emergency department is pain management. This study aimed to compare the analgesic effects of intravenous (IV) acetaminophen and morphine sulfate in this regard. Methods: This double blind clinical trial was conducted on >۱۸ years old renal colic patients in need of pain management in emergency department. Pain severity was recorded as ۱۵, ۳۰, and ۶۰ minutes before injection, and ۱۲۰ minutes after injection. In addition, side effects were compared between IV acetaminophen and morphine sulfate groups using SPSS version ۱۶. Results: A total of ۳۵۵ patients were randomly allocated to one of the treatment groups. There were no significant differences between the two groups regarding baseline characteristic of participants. There was no significant difference in the pain intensity of the groups; ۱۵ (P = ۰.۱۳) and ۳۰ (P = ۰.۱۵) minutes after treatment. Although, the difference in pain severity was statistically significant between the two groups; ۶۰ (P = ۰.۰۲) and ۱۲۰ (P = ۰.۰۰۳) minutes after the infusion. This was not clinically important. The prevalence of side effects in morphine group was higher than the acetaminophen group (RR: ۲.۱۴, ۹۵% CI: ۱.۵۳-۲.۹۸, P< ۰.۰۰۰۱). Conclusion: Based on the findings, IV morphine sulfate and acetaminophen had equal effectiveness regarding acute renal colic pain management, but considering the significantly higher frequency of side effects, IV acetaminophen seems to be a more reasonable choice in this regard.

Keywords:

Renal colic , Morphine , Acetaminophen , Pain management , Emergency Service