ORIGINAL ARTICLE

Comparison of intramuscular injection of ketorolac and conventional treatment in the field of cost-effectiveness, length of stay and pain relief in patients admitted to the emergency department with renal colic

Rosana Hexam , Mahdi Rezai, Delaram Delbari, Yasaman Sadat Keshmiri, Hamed Aghdam, Darab Zohri

Rosana Hexam
Research and Development Center of Firoozgar Hospital, Iran university of Medical Sciences, Tehran, Iran. Email: hessamroxana@yahoo.com

Mahdi Rezai
Emergency Medicine Management Research Center, Iran University of Medical Sciences, Tehran, Iran

Delaram Delbari
Student Research Committee, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran

Yasaman Sadat Keshmiri
Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Hamed Aghdam
Emergency Medicine Management Research Center, Iran University of Medical Sciences, Tehran, Iran

Darab Zohri
Trauma and Injury Research Center, Iran University of Medical Science, Tehran, Iran
Online First: October 29, 2018 | Cite this Article
Hexam, R., Rezai, M., Delbari, D., Keshmiri, Y., Aghdam, H., Zohri, D. 2018. Comparison of intramuscular injection of ketorolac and conventional treatment in the field of cost-effectiveness, length of stay and pain relief in patients admitted to the emergency department with renal colic. Bali Medical Journal 8(1): 83-87. DOI:10.15562/bmj.v8i1.1260


Background: Pain resulting from the stone passage is one of the most severe and intractable pain experiences. The aim of our study is evaluating the effect of intra-muscular ketorolac on pain reduction; reduce the length of stay and cost of patients with renal colic.

Methods: This was a randomized clinical trial study which held in an academic emergency department (ED). Based on defined criteria, 222 patients with renal colic were randomized in two groups: half of them received a single intramuscular injection of 30 mg ketorolac, and other 111 patients got conventional treatment (hydration, morphine sulfate). Demographic characteristics, pain score after 30 minutes, the length of stay in ED, complications as well as hospital costs were recorded for both groups.

Result: The baseline characteristics and pain score were similar in the two groups (p>0.05). Ketorolac was significantly (p<0.001) more effective than conventional treatment in reducing pain score. Those treated with ketorolac left the ED significantly earlier than those treated with conventional treatment (65.54; 95%CI, 59.7-71.5 vs. 193.1; 95%CI, 172.8-215.2 minutes, p<0.001). Drug adverse effects (nausea, dizziness, and drowsiness) and cost of ketorolac group were significantly lower than the control group (43310 Tomans (110$) (95% CI, 42590-44030) vs. 150410 Tomans (350$) (95% CI, 240100-70940). (p<0.001).

Conclusion: This study showed that intramuscular ketorolac as a single agent for renal colic is cost-effective and promotes earlier discharge of renal colic patients from the ED.

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