title: Usefulness of nefopam in treating pain of severe uncomplicated renal colics in adults admitted to emergency units: a randomised double-blind controlled trial. The 'INCoNU' study.
abstract: BACKGROUND
  Renal colic pain is a frequent cause of emergency department admissions (1-2% of admissions). It is extremely painful, often requiring intravenous morphine titration. The aim of this study was to estimate the effect of adding nefopam to ketoprofen upon subsequent morphine consumption and the time needed to achieve adequate analgesia in renal colic.
  
  
  METHODS
  The authors undertook a prospective, monocentric, randomised, double-blind, placebo-controlled, parallel-group study, using an intent-to-treat analysis. Patients admitted to the emergency department for suspected hyperalgesic (evaluated with a visual analogue scale (VAS)) renal colic were enrolled in the study. They were administered an initial treatment of ketoprofen before being randomly assigned to either the placebo or nefopam group.
  
  
  RESULTS
  Thirty patients admitted to the emergency department were enrolled in the study. Morphine analgesia was necessary for 10 patients (66.6%) (95% CI 40% to 90%) in the nefopam group and 8 (53.3%) (95% CI 30% to 80%) in the placebo group, with no statistically significant difference found (difference 13.3%, 95% CI -51% to 24%). The time needed to achieve adequate analgesia in the case of morphine titration was 8.3 min (95% CI 4.2 to 12.5) in the nefopam group and 9 min (95% CI 2.7 to 15.3) in the placebo group, with no statistically significant difference (difference 0.7, 95% CI 7.25 to 8.58).
  
  
  CONCLUSIONS
  This study did not reveal any significant difference between nefopam and placebo. This may be due to lack of statistical power or lack of effectiveness.
  
  
  BACKGROUND
  http://ClinicalTrials.gov ID number NCT00639574.
authors.affiliation: Pôle SAMU-SMUR-Urgences, CHU Clermont-ferrand, Hôpital Gabriel Montpied, Clermont-Ferrand, France. fmoustafa@chu-clermontferrand.fr
authors.forename: Farès
authors.initials: F
authors.lastname: Moustafa
authors.forename: Jérôme
authors.initials: J
authors.lastname: Liotier
authors.forename: Thierry
authors.initials: T
authors.lastname: Mathevon
authors.forename: Daniel
authors.initials: D
authors.lastname: Pic
authors.forename: Christophe
authors.initials: C
authors.lastname: Perrier
authors.forename: Jeannot
authors.initials: J
authors.lastname: Schmidt
mesh_terms: D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007660:Ketoprofen / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009340:Nefopam / Q000627:therapeutic use*; D011446:Prospective Studies; D056844:Renal Colic / Q000188:drug therapy*
chemical_list: D018712:Analgesics, Non-Narcotic; D009340:Nefopam; D007660:Ketoprofen