Ketorolac Versus Opioids For Renal Colic

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�PAGE � �PAGE �13� Ketorolac Versus Opioids


Ketorolac Versus Opioids For Renal Colic

Magdalena Swiderska


NUSC 527


Pain has been reported as the most common complaint of patients presenting to the emergency department (ED) (Karwowski et al., 2006). Studies have shown that pain is often insufficiently relieved, despite availability of numerous analgesic agents (Tanabe & Buschmann, 1999). Renal colic is one of the most painful conditions treated in ED. It is caused by a stone formed from collections of crystals that build up in the urine when the composition of certain compounds is in high enough concentration. The pain generated by renal colic is primarily caused by the dilation, stretching, and spasm provoked by the obstruction by the stones that dislodge from the kidney and move through the urinary tract until they are passed in the urine.

Kidney stone may present in different ways, but most commonly it is characterized as an excruciating pain in the flank and/or abdominal area, radiating to the groin, and is often accompanied by nausea and vomiting. Patients usually become agitated, restless, diaphoretic, and unable to find a comfortable position. Some state that renal colic is the most painful event a person can endure. Striking without warning, the pain is often described as being worse than childbirth, broken bones, burns, or surgery.

Although several diagnostic imaging modalities exist to confirm kidney stones, diagnosis is often based on the history and physical examination. Common therapy combines pain relief and hydration. Stones smaller than 5mm usually pass spontaneously, and some larger ones require surgical intervention for removal (Parmar, 2004). The choice of medication is based on availability, physician's experience and preference, and the norms of the institution. Intravenous analgesics are preferred as they...