Acute pain management in symptomatic cholelithiasis.
OBJECTIVE
To review the evidence for the use of different non-steroidal anti-inflammatory drugs (NSAIDs) in the treatment of biliary colic.


METHODS
The strategies employed included an extensive literature review for articles and studies related to biliary colic from electronic databases including PubMed, Science Direct, Wiley Inter Science, Medline and Cochrane from last 15 years. Keywords: "Biliary colic", "management of biliary colic", "non-steroidal anti-inflammatory drugs", "cholelithiasis" and "biliary colic management". Six randomized control trials, 1 non-randomized trial and 1 meta-analysis were included in this review. The outcomes of these studies and their significance have been reviewed in this paper.


RESULTS
Current evidence suggests there are no set protocols for biliary colic pain management. NSAIDs are potent in the management of biliary colic, not only in terms of symptom control but in disease progression as well. Apart from the studies on diclofenac and ketorolac, there are studies which have shown that intravenous tenoxicam and injectable flurbiprofen are equally effective in managing biliary colic. The efficacy of NSAIDs is superior in terms of lower number of doses and longer duration of action in comparison to other analgesic agents.


CONCLUSIONS
This literature review has found that NSAIDs are safe and effective for pain control in biliary colic, and reduce the likelihood of further complications.
Tahir Masudi, Helen Capitelli-McMahon, Suhail Anwar, York Hospitals NHS Foundation Trust, the York Teaching Hospital, North Yorkshire YO31 8HE, United Kingdom.
Tahir
T
Masudi
Tahir Masudi, Helen Capitelli-McMahon, Suhail Anwar, York Hospitals NHS Foundation Trust, the York Teaching Hospital, North Yorkshire YO31 8HE, United Kingdom.
Helen
H
Capitelli-McMahon
Tahir Masudi, Helen Capitelli-McMahon, Suhail Anwar, York Hospitals NHS Foundation Trust, the York Teaching Hospital, North Yorkshire YO31 8HE, United Kingdom.
Suhail
S
Anwar
Biliary colic; Biliary colic management; Cholelithiasis; Management of biliary colic; Non-steroidal anti-inflammatory drugs