title: Intravenous Morphine vs Intravenous Ketofol for Treating Renal Colic; a Randomized Controlled Trial.
abstract: BACKGROUND
  The main purpose of emergency department (ED) management for renal colic is prompt pain relief. The present study aimed to compare the analgesic effects of intravenus (IV) ketofol with morphine in management of ketorolac persistent renal colic.
  
  
  METHODS
  This study is a single blind randomized, clinical trial, on patients who were presented to ED with renal colic, whose pain was resistant to 30 mg IV ketorolac. The patients were randomly assigned to either IV morphine (0.1 mg/kg) or IV ketofol (0.75 mg/kg propofol and 0.75 mg/kg) and the measures of treatment efficacy were compared between the groups after 5 and 10 minutes.
  
  
  RESULTS
  90 patients with mean age of 38.01 ± 9.78 years were randomly divided into 2 groups of 45 (66.7% male). Treatment failure rate was significantly lower in ketofol group after 5 (20% vs 62.2%, p < 0.001) and 10 minutes (11.1% vs 44.4%, p < 0.001). ARR and NNT for ketofol after 5 miutes were 42.22% (95% CI: 23.86 - 60.59) and 3 (95% CI: 1.7 - 4.2), respectively. After 10 minutes, these measures reached 33.33 (95% CI:16.16 - 50.51) and 4 (95% CI: 2.0 - 6.2), respectively. NNH and ARI for hallucination or agitation were 12 (95%CI: 5.8 - 174.2) and 8.89% (0.57 - 17.20), respectively.
  
  
  CONCLUSIONS
  The results of the present study, showed the significant superiority of ketofol (NNT at 5 minute = 3 and NNT at 10 minute = 4) in ketorolac resistant renal colic pain management. However, its NNH of 12, could limit its routine application in ED for this purpose.
authors: Emergency Medicine Department, Maragheh University of Medical Sciences, Maragheh, Iran.
authors: Gholamreza
authors: G
authors: Faridaalaee
authors: Emergency Medicine Department, Urmia University of Medical Sciences, Urmia, Iran.
authors: Neda
authors: N
authors: Mohammadi
authors: International branch of Urmia University of Medical Sciences, Urmia, Iran.
authors: Seyedeh Zahra
authors: SZ
authors: Merghati
authors: Department of Community Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
authors: Fatemeh
authors: F
authors: Keyghobadi Khajeh
authors: Anesthesiology Department, Tabriz University of Medical Sciences, Tabriz, Iran.
authors: Bahman
authors: B
authors: Naghipour
authors: Department of Emergency Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
authors: Mahboob
authors: M
authors: Pouraghaei
authors: Emergency Medicine Department, Maragheh University of Medical Sciences, Maragheh, Iran.
authors: Sajjad
authors: S
authors: Ahmadi
keywords: Renal colic; ketamine; morphine; pain; propofol