title: Treatment of loin pain suspected to be renal colic with papaverine hydrochloride: a prospective double-blind randomised study.
abstract: OBJECTIVE
  • To assess the efficacy of papaverine hydrochloride combined with a diclofenac sodium suppository to relieve renal colic compared with diclofenac suppository monotherapy, as the effect of phosphodiesterase inhibitors on ureteric muscles might reduce the pain of renal colic.
  
  
  METHODS
  • A prospective, double-blind clinical study was performed. • In all, 550 patients aged 17-55 years with acute renal colic were randomised to two groups. Patients in one group (group A) received a diclofenac suppository (100 mg) plus saline 0.9% (placebo) and the other group (group B) received a diclofenac suppository (100 mg) plus intravenous (i.v.) papaverine hydrochloride (1.5 mg/kg up to 120 mg). • Pain intensity was assessed using a visual analogue scale (VAS) at 0, 20 and 40 min after treatment. Further analgesia was provided at the patients' request (25 mg pethidine intramuscularly).
  
  
  RESULTS
  • Baseline characteristics (sex, age, past history of similar pains) were similar in the two groups. • There were significant differences in VAS pain scores between 0 and 20 min and 0 and 40 min in both groups (P < 0.001). • At the end of study, 71.1% of patients in group A and 90.9% of patients in group B reported pain relief and did not require pethidine, respectively. • Significantly more patients in group A required further analgesia.
  
  
  CONCLUSIONS
  • According to our results, i.v. papaverine hydrochloride plus a diclofenac suppository were more effective than the diclofenac suppository alone for treating acute renal colic. • Therefore, i.v. papaverine hydrochloride is a beneficial supplemental therapy to relieve renal colic pain, particularly combined with non-steroidal anti-inflammatory drugs.
authors.affiliation: Urology Research Center, Guilan University of Medical Sciences, Razi Hospital, Rasht, Guilan, Iran.
authors.forename: Seyed Alaeddin
authors.initials: SA
authors.lastname: Asgari
authors.forename: Mani Mohiti
authors.initials: MM
authors.lastname: Asli
authors.forename: Ali Hamidi
authors.initials: AH
authors.lastname: Madani
authors.forename: Parvaneh Arab
authors.initials: PA
authors.lastname: Maghsoudi
authors.forename: Mandana Mansour
authors.initials: MM
authors.lastname: Ghanaei
authors.forename: Maryam
authors.initials: M
authors.lastname: Shakiba
authors.forename: Hamidreza Baghani
authors.initials: HB
authors.lastname: Aval
authors.forename: Ahmad
authors.initials: A
authors.lastname: Enshaei
authors.forename: Alireza
authors.initials: A
authors.lastname: Farzan
authors.forename: Samaneh
authors.initials: S
authors.lastname: Esmaeili
mesh_terms: D000208:Acute Disease; D059787:Acute Pain / Q000209:etiology / Q000517:prevention & control*; D000293:Adolescent; D000328:Adult; D000700:Analgesics / Q000008:administration & dosage*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D004008:Diclofenac / Q000008:administration & dosage; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010208:Papaverine / Q000008:administration & dosage*; D011446:Prospective Studies; D056844:Renal Colic / Q000188:drug therapy*; D013488:Suppositories; D055815:Young Adult
chemical_list: D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal; D013488:Suppositories; D004008:Diclofenac; D010208:Papaverine