NSAIDs better than opioids for kidney stone pain
Non-steroidal anti-inflammatory drugs appear slightly more effective than opioids in treating the pain associated with kidney stones, according to a systematic review published this week.
Doctors in Australia looked at randomised controlled trials comparing
any opioid with any NSAID in acute renal colic, providing the study reported
specific parameters of pain and adverse events.
They identified 20 trials involving a total of 1,613 patients. Both NSAIDs
and opioids led to clinically important reductions in patient reported
pain scores. However, NSAIDs were shown to have slightly better efficacy
than opioids for relieving the pain of acute renal colic.
NSAIDs were also linked with a reduced likelihood of needing rescue analgesia.
Pooled analysis of suitable trials showed a greater reduction in pain
scores for patients treated with NSAIDs than opioids. Despite these findings,
the two drug classes did not differ significantly in the proportion of
patients achieving complete pain relief. Most trials showed a higher
incidence of adverse events in patients given opioids. Opioids, particularly
pethidine, were associated with a higher rate of vomiting than NSAIDs
(BMJ 2004;328:1401). |
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