title: A retrospective analysis of nebulized versus intravenous fentanyl for renal colic.
abstract: OBJECTIVE
  To assess the effectiveness of nebulized fentanyl used for analgesia in renal colic.
  
  
  METHODS
  This research was planned as a randomized, blinded study in which prospectively collected data were analyzed retrospectively to compare nebulized and intravenous (iv) fentanyl therapies. Patients with renal colic with 'moderate' or worse pain on a four-point verbal pain score (VPS) or with pain of 20mm or above on a 100-mm visual analogue score (VAS) at time of presentation were randomized into iv fentanyl (n=62) or nebulized fentanyl (n=53) study groups. Decreases in VAS and VPS scores at 15 and 30min compared to baseline, rescue analgesia requirements and side-effects between the groups were compared.
  
  
  RESULTS
  Both iv fentanyl and nebulized fentanyl provided effective analgesia in renal colic patients at the end of 30min. However, iv fentanyl provided more rapid and more effective analgesia than nebulized fentanyl. Patients receiving iv fentanyl had lower rescue analgesia requirements than those receiving nebulized fentanyl (37.1% vs 54.7%), although the difference was not statistically significant (p=0.058). In addition, side-effects were more common in the iv fentanyl group compared to the nebulized fentanyl group (22.1% vs 9.4%), although the difference was also not significant (p=0.058).
  
  
  CONCLUSIONS
  Nebulized fentanyl provides effective analgesia in patients with renal colic. However, iv fentanyl exhibits more rapid and more powerful analgesic effects than nebulized fentanyl. Nonetheless, due to its ease of use and few potential risks and side-effects the nebulized form can be used as an alternative in renal colic.
authors.affiliation: Karadeniz Technical University, Faculty of Medicine, Department of Emergency Medicine, Trabzon, Turkey.
authors.forename: Melih
authors.initials: M
authors.lastname: Imamoglu
authors.affiliation: Karadeniz Technical University, Faculty of Medicine, Department of Emergency Medicine, Trabzon, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Aygun
authors.affiliation: Karadeniz Technical University, Faculty of Medicine, Department of Emergency Medicine, Trabzon, Turkey.
authors.forename: Omer
authors.initials: O
authors.lastname: Bekar
authors.affiliation: Karadeniz Technical University, Faculty of Medicine, Department of Emergency Medicine, Trabzon, Turkey.
authors.forename: Erkan
authors.initials: E
authors.lastname: Erdem
authors.affiliation: Karadeniz Technical University, Faculty of Medicine, Department of Emergency Medicine, Trabzon, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Cicek
authors.affiliation: Karadeniz Technical University, Faculty of Medicine, Department of Emergency Medicine, Trabzon, Turkey.
authors.forename: Ozgur
authors.initials: O
authors.lastname: Tatli
authors.affiliation: Karadeniz Technical University, Faculty of Medicine, Department of Emergency Medicine, Trabzon, Turkey.
authors.forename: Yunus
authors.initials: Y
authors.lastname: Karaca
authors.affiliation: Karadeniz Technical University, Faculty of Medicine, Department of Emergency Medicine, Trabzon, Turkey.
authors.forename: Aynur
authors.initials: A
authors.lastname: Sahin
authors.affiliation: Karadeniz Technical University, Faculty of Medicine, Department of Emergency Medicine, Trabzon, Turkey.
authors.forename: Suha
authors.initials: S
authors.lastname: Turkmen
authors.affiliation: Karadeniz Technical University, Faculty of Medicine, Department of Emergency Medicine, Trabzon, Turkey. Electronic address: suleymanturedi@hotmail.com.
authors.forename: Suleyman
authors.initials: S
authors.lastname: Turedi
mesh_terms: D000280:Administration, Inhalation; D061605:Administration, Intravenous; D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D009330:Nebulizers and Vaporizers; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D059408:Pain Management; D016032:Randomized Controlled Trials as Topic; D056844:Renal Colic / Q000150:complications / Q000188:drug therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome; D064232:Visual Analog Scale
chemical_list: D000701:Analgesics, Opioid; D005283:Fentanyl
keywords: Acute renal colic; Analgesics; Fentanyl; Renal colic; Ureteral colic