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Ondansetron versus diclofenac sodium in the treatment of acute ureteral colic: A double blind controlled trial

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Abstract

The aim of this study is to compare the effectiveness of the 5-HT3 antagonist, ondansetron and a non-steroidal anti-inflammatory agent, diclofenac sodium, as a pain reliever in the treatment of acute ureteral colic. Sixty four patients with severe or moderate pain who were clinically diagnosed as having ureteral colic associated with microscopic or gross hematuria were included in the study. Thirty three patients were administered ondansetron and 31 patients were administered diclofenac sodium. Exclusion critera were known kidney or liver disease causing dysfunction, known hypersensitivity to ondansetron or diclofenac sodium, pregnancy, lactation, duodenal ulcer or bleeding. After pain assessment with a verbal scale and a visual analog scale (VAS), we randomized patients and administered 8 mg ondansetron intravenously to 33 patients and 75 mg diclofenac sodium intramuscularly to 31 patients and pain scores were recorded every 15 minutes. If significant pain relief was not achieved within 60 minutes, IV meperidine was given as rescue pain medication. Ondansetron was effective as a primary pain reliever in 14 (42.4%) patients, whereas 19 patients required additional medication. Diclofenac sodium was effective as a primary pain reliever in 24 (77.4%) patients, whereas 7 patients required additional medication. Ondansetron was not superior to diclofenac sodium in relieving pain in patients with acute ureteral colic.

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References

  1. Lingemen JE, Steidle CP, Adams MC. Calculous disease of the kidney and bladder. In: Harwood-Nuss A, ed. The Clinical Practice of Emergency Medicine. Philadelphia: JB Lippincott, 1991.

    Google Scholar 

  2. Johnston H, Herzog J, Laurel D. Effects of prostaglandin E2 on renal hemodynamic sodium and water excretion. Am J Physiol 1967; 213: 939–946.

    Google Scholar 

  3. Olsen U, Magnussen M, Eilertssen E. Prostaglandins, alink between hydro and haemodynamic in dog. Acta Physiol Scand 1976; 97: 369–376.

    Google Scholar 

  4. Holmlund D. Ureteral stones: an experimental and clinical study of the mechanism of passage of arrest of ureteral stones. Scand J Urol Nephrol 1968; 1 (Suppl 1): 1–80.

    Google Scholar 

  5. Holmlund D, Sjodin J. Treatment of ureteral colic with intravenous indomethacin. J Urol 1978; 75: 25–27.

    Google Scholar 

  6. Holmlund D. The pathophysiology of ureteral colic. Scand J Urol Nephrol 1983; Suppl 75: 25–27.

    Google Scholar 

  7. Van Laecke E, Oosterlinck W. Physiopathology of renal colic and the therapeutic consequences. Acta Urol Belg 1994; 62: 15–18.

    Google Scholar 

  8. Labrecque M, Dostaler LP, Rouselle R, Nguyen T, Poirier S.Efficacy of nonsteroidal anti-inflammatory drugs in the treatment of acute renal colic. A meta-analysis. Arch Intern Med

  9. 1994; 154: 1381–1387.

  10. Supervia A, Pedro-Botet J, Nogues X, Echarte JL, Minguez S, Iglesias ML, Gelabert A. Piroxicam fast-dissolving dosage form vs diclofenac sodium in the treatment of acute renal colic: a double-blind controlled trial Br J Urol 1998 Jan; 81(1): 27–30.

    Google Scholar 

  11. Chetwood CH. The Practice of Urology: A Surgical Treatise on Genito-urinary Diseases Including Syphilis, 2nd ed. New York: William Wood and Company, 1916: 568–569.

  12. Khalifa MS, Sharkawi MA. Treatment of pain owing to acute ureteral obstruction with prostaglandin-synthetase inhibitor: a prospective study. J Urol 1986; 136: 393–396.

    Google Scholar 

  13. Holmlund D, Sjodin J-G. Treatment of ureteral colic with intravenous indomethacin. J Urol 1978; 120: 676–677.

    Google Scholar 

  14. Larsen LS, Miller A, Allegra JR. The use of intravenous ketorolac for the treatment of renal colic in the emergency department. Am J Emerg Med 1993; 11: 197–199.

    Google Scholar 

  15. Lundstam SO, Wahlander LA, Kral GJ. Treatment of ureteral colic by prostaglandin synthetase inhibition with diclofenac sodium. Curr Ther Res 1980; 28: 355–358.

    Google Scholar 

  16. Lundstam SO, Wahlander LA, Leissner KH, Kral GJ. Prostaglandin-synthetase inhibition with diclofenac sodium in the treatment of renal colic: comparison with use of a narcotic analgesic. Lancet 1982; 8281: 1096–1097.

    Google Scholar 

  17. Collaborative Group of the Spanish Society of Clinical Pharmacology. Comparative study of the efficacy of dipyrone, diclofenac sodium and pethidine in acute renal colic. Eur J Clin Pharmacol 1991; 40: 543–546.

    Google Scholar 

  18. Stein A, Ben Dov D, Finkel B, Mecz Y, Kitzes R, Lurie A. Single-dose intramuscular ketorolac versus diclofenac for pain management in renal colic. Am J Emerg Med 1996; 14: 385–387.

    Google Scholar 

  19. Stankov G, Schmieder G, Zerle G, Schinzel S, and Brune K. Double-blind study with dipyrone versus tramadol and butylscopolamine in acute renal colic pain.World J Urol 1994; 12: 155–161.

    Google Scholar 

  20. Burkhalter A, Julius D, Frick OL. Histamine, Serotonin and Ergot Alkaloids. In: Katzung BG editor. Basic and Clinical Pharmacology. Appleton & Lange, USA, 1995: 262.

    Google Scholar 

  21. Gidener S, Kirkali Z, Güven H. Influence of serotonin on the human ureter: an in vitro pharmacological study. Urol Int 1995; 55: 202–204.

    Google Scholar 

  22. Joss RA, Bacchi M, Buser K, Kirchner V, Neuenscwander H, Orth B, Aapro MS, Thurlimann B. Ondansetron plus dexamethasone is superior to ondansetron alone in the prevention of emesis in chemotheraphy-naïve and previously treated patients. Swiss Group for Clinical Cancer Research (SAKK). Ann Oncol 1994; 5(3): 253–238.

    Google Scholar 

  23. Cole RM, Robinson F, Harvel L, Trethowan K, Murdoch V. Successful control of intractable nausea and vomiting requiring combined ondansetron and haloperidol in a patient with advanced cancer. J Pain Symptom Manage 1994; 9: 48–50.

    Google Scholar 

  24. Madsen MR, Jensen KE. Postoperative pain and nausea after laparascopic cholecystectomy. Sug Laparosc Endosc 1992; 2303–2305.

  25. Ergene Ñ, Fowler J, Karc?o?glu Ö, K?rkal? Z. Ondansetron for primary pain relief in ureteral colic. SDÑ T?p Dergisi 1999; 6(1): 27–30.

    Google Scholar 

  26. Miralles R, Cami J, Gutierrez J, Torne J, Garces JM, Badenas JM. Diclofenac versus dipyrone in acute renal colic: a double-blind controlled trial. Eur J Pharmacol 1987; 33: 527–528.

    Google Scholar 

  27. Kinn AC, Elabarouni J, Seideman P, Sollevi A. The effect of diclofenac sodium on renal function. Scand J Urol Nephrol 1989; 23: 153–157.

    Google Scholar 

  28. Sanahuja J, Corbera G, Garau J, Pla R, Carre MC. Intramuscular diclofenac sodium versus intravenous Baralgin in the treatment of renal colic. DICP 1990; 24: 361–364.

    Google Scholar 

  29. Collaborative Group of the Spanish Society of Clinical Pharmacology. Comparative study of the efficacy of dipyrone, diclofenac sodium and pethidine in acute renal colic. Eur J Clin Pharmacol 1991; 40: 543–546.

    Google Scholar 

  30. Marthak KV, Gokarn AM, Rao AV et al. A multicentre comparative study of diclofenac sodium and penthidine in renal colic patients in India. Curr Med Res Opin 1991; 12: 366–373.

    Google Scholar 

  31. Muriel C., Ortiz P. Efficacy of two different intramuscular doses of dipyrone in acute renal colic. Cooperative Study Group. Methods Find Exp Clin Pharmacol 1993; 15: 465–469.

    Google Scholar 

  32. Al-Waili NSD. Intramuscular tenoxicam to treat acute renal colic. Br J Urol 1996; 77: 15–16.

    Google Scholar 

  33. Cordell WH, Wright SW, Wolfson AB et al. Comparison of intravenous ketorolac, meperidine, and both (balanced analgesia) for renal colic. Ann EmergMod 1996; 28: 151–158.

    Google Scholar 

  34. Labrecque M, Dostaler LP, Rouselle R, Nguyen T, Poirier S. Efficacy of nonsteroidal anti-inflammatory drugs in the treatment of acute renal colic. A meta-analysis. Arch Intern Med 1994; 154: 1381–1387.

    Google Scholar 

  35. Comeri G, Radice GP, Duvia R, Manganini V, Monza G. Efficacy and safety of non-steroidal anti-inflammatory drugs in ureteral colic. In: Schwille PO et al. eds. A Double-Blind Contrelled Trial. Urolithiasis and Related Clinical Research. New York: Plenum Press, 1985.

    Google Scholar 

  36. Holmlund D, Sjödin J-G. Indomethacin in the treatment of ureteral colic. Surg Forum 1978; 29: 639–641.

    Google Scholar 

  37. Laerum E, Ommundsen OE, Gronseth JE, Christiansen A, Fagertun HE. Oral diclolfenac in the treatment of recurrent renal colic. A double-blind comparison with placebo. Eur Urol 1995; 28: 108–111.

    Google Scholar 

  38. Marthak KV, Gokarn AM, Rao AV, Sane SP, Mahanta RK, Sheth RD, Chavda KD, Rane BS, Vaidya AB. A multi-centre comparative study of diclofenac sodium and a dipyrone spasmolytic combination, and a single-centre comparative study of diclofenac sodium and pethidine in renal colic patients in India. Curr Med Res Opin 1991; 12: 366–373.

    Google Scholar 

  39. Kirkali Z, Whitaker RH. The use of oxybutynin in urological practice. Int Urol Nephrol 1987; 19: 385–391.

    Google Scholar 

  40. Ye JH, Mui WC, Ren J, Hunt TH, Wu WH, Zbuzek VK. Ondansetron exhibits the properties of a local anesthetic. Anesth Analg 1997; 85: 1116–1121.

    Google Scholar 

  41. Doenicke A, Mayer M, Vogginger T. Postoperative pain therapy. Anaesthesist 1993; 42: 800–806.

    Google Scholar 

  42. Paxton LD, McKay AC, Mirakhur RK. Prevention of nausea and vomiting after day case gynaecological laparoscopy. A comparison of ondansetron, droperidol, metoclopramide and placebo. Anaesthesia 1995; 50: 403–406.

    Google Scholar 

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Authors and Affiliations

  1. Department of Emergency Medicine, Dokuz Eylül University School of Medicine, Denmark

    Ulku Ergene, Murat Pekdemir, John Fowler & Figen Coşkun

  2. Department of Urology, Dokuz Eylül University School of Medicine, Denmark

    Erdem Canda & Ziya Kırkalı

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  1. Ulku Ergene
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  2. Murat Pekdemir
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  3. Erdem Canda
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  4. Ziya Kırkalı
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  5. John Fowler
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  6. Figen Coşkun
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Ergene, U., Pekdemir, M., Canda, E. et al. Ondansetron versus diclofenac sodium in the treatment of acute ureteral colic: A double blind controlled trial. Int Urol Nephrol 33, 315–319 (2001). https://doi.org/10.1023/A:1015270224183

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