Intravenous single-dose tramadol versus meperidine for pain relief in renal colic.
OBJECTIVE
Comparison of the effectiveness of tramadol with meperidine given intravenously to emergency patients with suspected renal colic.


METHODS
A double-blind, randomized clinical trial was performed in the Emergency Department of a tertiary-care university hospital. Consecutive patients with suspected renal colic (n = 47) were randomized to receive intravenously an initial dose of tramadol 50 mg (n = 23) or meperidine 50 mg (n = 24). After 30 min, additional doses of meperidine 50 mg were given intravenously as a rescue medication in an open fashion. Pain relief was assessed using a 10 cm visual analogue scale, the primary outcomes being pain relief at 15 and 30 min after the analgesics. Secondary outcomes were the frequency of rescue meperidine use and the development of side-effects.


RESULTS
Visual analogue scale pain scores after 15 and 30 min decreased in both tramadol and meperidine groups (P < 0.05). However, pain relief was better in the meperidine group at the 15 and 30 min evaluations (P < 0.05). Only 11 patients (48%), initially receiving meperidine, needed more meperidine compared with 16 patients (67%) initially receiving tramadol. Both drugs were well tolerated with no adverse effects occurring in either group.


CONCLUSIONS
Meperidine 50 mg was superior to tramadol 50 mg for acute pain relief in patients with suspected renal colic when given intravenously. Because many patients in both groups received supplemental meperidine and the response to tramadol alone cannot be predicted, clinicians may want to choose higher doses of meperidine alone or other alternative combinations.
Eray
O
O
Akdeniz University School of Medicine, Department of Emergency Medicine, Antalya, Turkey. oeray@med.akdeniz.edu.tr
Cete
Y
Y
Oktay
C
C
Karsli
B
B
Akça
S
S
Cete
N
N
Ersoy
F
F
D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000627:therapeutic use; D003085:Colic / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D007674:Kidney Diseases / Q000188:drug therapy*; D008297:Male; D008614:Meperidine / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods*; D014147:Tramadol / Q000008:administration & dosage* / Q000627:therapeutic use; D016896:Treatment Outcome
D000701:Analgesics, Opioid; D014147:Tramadol; D008614:Meperidine