Ismail, Azirawati
(2016)
The effectiveness of intravenous parecoxib sodium as an analgesic alternative to morphine in suspected acute renal colic in Emergency Department Hospital Universiti Sains Malaysia.
Masters thesis, Universiti Sains Malaysia.
Abstract
Background : Patients with renal colic usually presented to Emergency Department
with severe and excruciating pain. Emergency Physicians using numerous medications
to treat the problem, however none of them had been proven to relieve the pain
completely. This study aimed to compare the effectiveness of IV parecoxib versus IV
morphine in suspected acute renal colic in Emergency Department . Objectives : The
objectives of this study were comparison between IV parecoxib sodium and morphine
in Emergenency Department HUSM regarding pain score reduction among acute renal
colic patient over time, mean pain score reduction by group over time and to compare
the effectiveness of both analgesics (reduction by 2 pain scores) after 5 minutes of drug
administration. The side effects of both drugs will be evaluated too. Methods : A
randomized, single-blinded study comparing IV parecoxib 40 mg versus IV morphine
at 0.10 mg/kg was conducted in adult patients who presented with features suggestive
of acute renal colic and NRS of 6 or more. Periodic assessment of vital signs and NRS
were taken at 0, 5, 15 and 30 minutes as well as evaluation of side effects within 30
minutes after the administration of the study drugs. The primary outcome was the
reduction of NRS. The data was analyzed by repeated measures ANOVA analysis.
Results : There was no significant difference in the mean NRS between patients in IV
parecoxib group and morphine group over time (F(3,126)=0.229, P=0.876).
Comparison of the effectiveness at 5 minutes between the groups was not significant
(P=0.498). Dizziness, vomiting and nausea were experienced in 22.7%, 13.6% and4.5% of patients respectively in IV morphine group as compared to parecoxib group
4.5% experienced of nausea only. Conclusions : There was no significant difference in
NRS between the groups over time, as well as in term of the effectiveness at 5 minutes.
Due to lack of IV parecoxib side effect compared to morphine, IV parecoxib seemed to
be valuable in the future and can be used as analgesic alternative to morphine in acute
renal colic as well as extended further to treat a variety of cases presented in ED
HUSM.
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