Treatment of biliary colic with diclofenac: a randomized, double-blind, placebo-controlled study.
OBJECTIVE
Nonsteroidal anti-inflammatory drugs (NSAIDs) have been used to relieve biliary colic. Follow-up was limited in previous studies, and the role of NSAIDs in the natural history of biliary colic has not been clarified. The purpose of this study was to evaluate the efficacy of diclofenac, a potent NSAID, in the the immediate symptomatic relief of biliary colic and the prevention of cholelithiasis-related complications.


METHODS
Fifty-three patients with cholelithiasis and biliary colic were enrolled in this randomized, double-blind, placebo-controlled study. They received a single 75-mg (3 mL) intramuscular injection of diclofenac (n = 27) or similarly administered 3 mL of saline (n = 26). All patients were followed up for at least 3 days. The effect of either treatment was assessed by changes in the severity of pain and the development of cholelithiasis-related complications.


RESULTS
Complete relief of pain was obtained in 21 diclofenac and in 7 placebo patients; progression to acute cholecystitis was observed in 4 and 11 patients, respectively. Fewer overall complications were observed in the diclofenac group.


CONCLUSIONS
In patients with cholelithiasis who present with biliary colic, a single 75-mg intramuscular dose of diclofenac can provide satisfactory pain relief and decrease substantially the rate of progression to acute cholecystitis.
Akriviadis
E A
EA
University of Southern California Liver Unit, Rancho Los Amigos Hospital, Downey 90242, USA.
Hatzigavriel
M
M
Kapnias
D
D
Kirimlidis
J
J
Markantas
A
A
Garyfallos
A
A
D000208:Acute Disease; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D001660:Biliary Tract Diseases / Q000188:drug therapy* / Q000209:etiology; D002764:Cholecystitis / Q000517:prevention & control; D002769:Cholelithiasis / Q000150:complications*; D003085:Colic / Q000188:drug therapy* / Q000209:etiology; D004008:Diclofenac / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D013997:Time Factors
D000894:Anti-Inflammatory Agents, Non-Steroidal; D004008:Diclofenac