title: Role of papaverine hydrochloride administration in patients with intractable renal colic: randomized prospective trial.
abstract: OBJECTIVE
  To evaluate the therapeutic effect of papaverine hydrochloride in the treatment of patients with renal colic pain unresponsive to conventional treatment.
  
  
  METHODS
  From March 2007 to January 2008, a total of 561 patients with severe renal colic pain due to a ureteral stone were treated with conventional agents (hyoscine-N-butylbromide and diclofenac sodium) in the emergency and urology departments. Of these 561 patients, 110, with no response to the treatment and persistent severe pain, were randomized into 3 groups for additional treatment. The patients in group 1 (n = 37) received intravenous hyoscine-N-butylbromide, those in group 2 (n = 37) received papaverine hydrochloride, and those in group 3 (n = 36) received pethidine. Before and after treatment, all patients completed a visual analog scale (VAS) questionnaire, with a scale of 0 (no pain) to 10 (maximal complaint), to measure their subjective pain. The mean VAS score of each group was compared with that of the other groups.
  
  
  RESULTS
  The pretreatment mean VAS scores of all 3 groups were not significantly different statistically from each other (4.02 +/- 1.20, 4.36 +/- 1.97, and 4.27 +/- 1.50; P > .05). However, after treatment, the mean VAS scores of the patients treated with papaverine (0.93 +/- 0.29) and pethidine (0.81 +/- 0.38) were significantly different from those of the hycosine group (3.67 +/- 2.21; P < .001). However, the mean VAS scores of groups 2 and 3 were comparable (P = .67). Unlike opioids, no papaverine-related severe side effects were observed.
  
  
  CONCLUSIONS
  Our results indicate that papaverine hydrochloride can used in an effective manner in the management of renal colic pain in patients unresponsive to commonly used conventional agents.
authors.affiliation: Department of Urology, Yeditepe University Hospital, Istanbul, Turkey. fyencilek@yeditepe.edu.tr
authors.forename: Faruk
authors.initials: F
authors.lastname: Yencilek
authors.forename: Can
authors.initials: C
authors.lastname: Aktas
authors.forename: Cemal
authors.initials: C
authors.lastname: Goktas
authors.forename: Cemil
authors.initials: C
authors.lastname: Yilmaz
authors.forename: Ugur
authors.initials: U
authors.lastname: Yilmaz
authors.forename: Kemal
authors.initials: K
authors.lastname: Sarica
mesh_terms: D000293:Adolescent; D000328:Adult; D003085:Colic / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010148:Intractable Pain / Q000188:drug therapy* / Q000209:etiology; D010208:Papaverine / Q000627:therapeutic use*; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use*; D011446:Prospective Studies; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000150:complications*
chemical_list: D010726:Phosphodiesterase Inhibitors; D010208:Papaverine