title: Comparison of intranasal ketamine versus IV morphine in reducing pain in patients with renal colic.
abstract: BACKGROUND
  Various drugs have been used to relieve abdominal pain in patients with renal colic. Ketamine is a popular choice as an analgesic.
  
  
  OBJECTIVE
  To compare the effectiveness of intranasal (IN) ketamine versus intravenous (IV) morphine in reducing pain in patients with renal colic.
  
  
  METHODS
  A randomized double-blind controlled trial was performed in 53 patients with renal colic recruited from the emergency department (ED) in 2015. Finally, 40 patients were enrolled in this study. Patients in the ketamine group received IN ketamine 1 mg/kg and IV placebo while patients in the control group received IV morphine 0.1mg/kg and IN placebo. Our goal was to assess visual analogue scale (VAS) changes between the 2 groups. Patients' VAS scores were reported before and 5, 15, 30min after drug injection.
  
  
  RESULTS
  Before drug administration, the mean±SD VAS score was 7.40±1.18 in the morphine group (group A) and 8.35±1.30 in the ketamine group (group B) (P-value=0.021). After adjustment by the appropriate analysis, the mean±SD VAS score in group (A) and (B) at 5min were (6.07±0.47 vs 6.87±0.47; mean difference -0.79, 95% confidence interval (CI) -1.48 to -1.04) (P-value=0.025), at 15 and 30min, the mean±SD VAS score in group (A) and (B) were (5.24±0.49 vs 5.60±0.49; mean difference -0.36, 95% CI -1.08 to 0.34) and (4.02±0.59 vs 4.17±0.59; mean difference -0.15, 95% CI -1.02 to 0.71) (P-value=0.304 and 0.719) respectively.
  
  
  CONCLUSIONS
  IN ketamine may be effective in decreasing pain in renal colic.
authors.affiliation: Kermanshah University of Medical Sciences, Imam Reza Hospital, Emergency Medicine Department, Kermanshah, Iran.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Farnia
authors.affiliation: Tehran University of Medical Sciences, Shariati Hospital, Emergency Medicine Department, Tehran, Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Jalali
authors.affiliation: Emergency Medicine Research Center, Emergency Medicine Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Elnaz
authors.initials: E
authors.lastname: Vahidi
authors.affiliation: Emergency Medicine Research Center, Emergency Medicine Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Momeni
authors.affiliation: Emergency Medicine Research Center, Emergency Medicine Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Javad
authors.initials: J
authors.lastname: Seyedhosseini
authors.affiliation: Emergency Medicine Research Center, Emergency Medicine Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: m_saeedi@tums.ac.ir.
authors.forename: Morteza
authors.initials: M
authors.lastname: Saeedi
mesh_terms: D015746:Abdominal Pain / Q000188:drug therapy* / Q000209:etiology; D000281:Administration, Intranasal; D061605:Administration, Intravenous; D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use; D000778:Anesthetics, Dissociative / Q000008:administration & dosage / Q000627:therapeutic use; D004311:Double-Blind Method; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007492:Iran; D007649:Ketamine / Q000008:administration & dosage* / Q000627:therapeutic use; D008297:Male; D009020:Morphine / Q000008:administration & dosage* / Q000627:therapeutic use; D059408:Pain Management / Q000379:methods; D010147:Pain Measurement; D056844:Renal Colic / Q000150:complications / Q000188:drug therapy*
chemical_list: D000701:Analgesics, Opioid; D000778:Anesthetics, Dissociative; D007649:Ketamine; D009020:Morphine
keywords: Intranasal; Ketamine; Morphine; VAS