title: [Management of ureteric colic with ketorolac and nifedipin vs. ketorolac and tamsulosin in the emergency room].
abstract: BACKGROUND
  Ureteric colic is the most common symptom of lithiasis. It is caused by the presence of stones accumulated in the renal papillae. These stones often migrate down the ureter, causing a ureteric colic, characterized by a severe pain in the lumbar region. The aim of this study was to compare the use of ketorolac and nifedipine vs. ketorolac and tamsulosin for the medical treatment of pain caused by stones in the lower ureter.
  
  
  METHODS
  Longitudinal study of 150 patients of 21-years or older with stones in the lower third of the ureter. 50% received ketorolac and nifedipine and the other 50%, ketorolac and tamsulosin. The Numeric Pain Rating Scale (NPRS) was used for the assessment of pain at admission and 4 and 12 hours after the treatment was administered. We used descriptive and inferential statistics (Mann-Whitney-Wilcoxon, chi-squared and Poisson regression).
  
  
  RESULTS
  Mean age was 38.17 years; 54.7% were male and 45.3% female. NPRS mean was 9.69 (initially), 7.42 (at 4 hours) and 2.05 (at 12 hours). There were no significant differences in the initial measurement of pain between groups (p < 0.005); four and 12 hours later the pain decreased more in patients managed with ketorolac and nifedipine, p = 0.0041. There were no complications nor side effects in both treatments.
  
  
  CONCLUSIONS
  The use of ketorolac and nifedipine is more effective than the use of ketorolac and tamsulosin for the management of pain caused by lower ureteral colic during the first 12 hours of treatment.
authors.affiliation: División de Investigación en Salud, Hospital de Traumatología y Ortopedia, Centro Médico Nacional "Manuel Ávila Camacho", Instituto Mexicano del Seguro Social, Puebla, Puebla, México. dralmoja@hotmail.com.
authors.forename: Álvaro J
authors.initials: ÁJ
authors.lastname: Montiel-Jarquín
authors.forename: Valeria M
authors.initials: VM
authors.lastname: Rocha-Rocha
authors.forename: Hugo A
authors.initials: HA
authors.lastname: Solís-Mendoza
authors.forename: María S
authors.initials: MS
authors.lastname: Romero-Figueroa
authors.forename: Ivet
authors.initials: I
authors.lastname: Etchegaray-Morales
authors.forename: Ivan
authors.initials: I
authors.lastname: Alvarado-Ortega
mesh_terms: D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D020910:Ketorolac / Q000627:therapeutic use*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009543:Nifedipine / Q000627:therapeutic use*; D010147:Pain Measurement; D056844:Renal Colic / Q000175:diagnosis / Q000188:drug therapy*; D013449:Sulfonamides / Q000627:therapeutic use*; D000077409:Tamsulosin; D016896:Treatment Outcome; D064804:Urological Agents / Q000627:therapeutic use*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D013449:Sulfonamides; D064804:Urological Agents; D000077409:Tamsulosin; D009543:Nifedipine; D020910:Ketorolac
keywords: Ketorolac; Nifedipine; Pain; Ureteral colic